Provider Demographics
NPI:1790112613
Name:CHIKANI, ASHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:CHIKANI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9328 SAYRE AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1228
Mailing Address - Country:US
Mailing Address - Phone:312-671-2742
Mailing Address - Fax:
Practice Address - Street 1:2211 SANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6150
Practice Address - Country:US
Practice Address - Phone:847-559-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051291977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist