Provider Demographics
NPI:1720365711
Name:SHAH, RESHMA M (PHARM D)
Entity Type:Individual
Prefix:
First Name:RESHMA
Middle Name:M
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 TURNBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8342
Mailing Address - Country:US
Mailing Address - Phone:312-952-6530
Mailing Address - Fax:
Practice Address - Street 1:877 TURNBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8342
Practice Address - Country:US
Practice Address - Phone:312-952-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist