Provider Demographics
NPI:1841568672
Name:CHHOKAR, BALJEET S (RPH)
Entity Type:Individual
Prefix:
First Name:BALJEET
Middle Name:S
Last Name:CHHOKAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 BRIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-4620
Mailing Address - Country:US
Mailing Address - Phone:219-322-5305
Mailing Address - Fax:
Practice Address - Street 1:770 JOLIET ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1720
Practice Address - Country:US
Practice Address - Phone:219-322-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017908A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist