Provider Demographics
NPI:1659654044
Name:JANI, NEEL H (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:NEEL
Middle Name:H
Last Name:JANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3500
Mailing Address - Country:US
Mailing Address - Phone:630-993-0869
Mailing Address - Fax:
Practice Address - Street 1:200 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-3500
Practice Address - Country:US
Practice Address - Phone:630-993-0869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist