Provider Demographics
NPI:1265868509
Name:KSHIRSAGAR, POOJA P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:P
Last Name:KSHIRSAGAR
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 1:975 ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2221
Mailing Address - Country:US
Mailing Address - Phone:847-810-8086
Mailing Address - Fax:
Practice Address - Street 1:975 ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2221
Practice Address - Country:US
Practice Address - Phone:847-810-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist