Provider Demographics
NPI:1992184899
Name:AULAKH, MANINDER
Entity Type:Individual
Prefix:
First Name:MANINDER
Middle Name:
Last Name:AULAKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 FARMHILL CIR
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1795
Mailing Address - Country:US
Mailing Address - Phone:847-526-8842
Mailing Address - Fax:
Practice Address - Street 1:330 FARMHILL CIR
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-1795
Practice Address - Country:US
Practice Address - Phone:847-526-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.288342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist