Provider Demographics
NPI:1720303977
Name:RAJPUT, ASHISHKUMAR R (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ASHISHKUMAR
Middle Name:R
Last Name:RAJPUT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8104 N OTTAWA AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2816
Mailing Address - Country:US
Mailing Address - Phone:847-802-9226
Mailing Address - Fax:203-886-2140
Practice Address - Street 1:8104 N OTTAWA AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2816
Practice Address - Country:US
Practice Address - Phone:847-802-9226
Practice Address - Fax:203-886-2140
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.287674183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051-287674OtherLICENSE NUMBER