Provider Demographics
NPI:1700481553
Name:THAKKAR, URVASHI N (PHARM D)
Entity Type:Individual
Prefix:
First Name:URVASHI
Middle Name:N
Last Name:THAKKAR
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 1:680 S SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2368
Mailing Address - Country:US
Mailing Address - Phone:224-766-6102
Mailing Address - Fax:
Practice Address - Street 1:680 S SUTTON RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-2368
Practice Address - Country:US
Practice Address - Phone:224-766-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist