Provider Demographics
NPI:1720683469
Name:SAFVI, AFSHAN R
Entity Type:Individual
Prefix:
First Name:AFSHAN
Middle Name:R
Last Name:SAFVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 S EOLA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-6485
Mailing Address - Country:US
Mailing Address - Phone:630-499-4391
Mailing Address - Fax:630-499-4396
Practice Address - Street 1:2211 S EOLA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60503-6485
Practice Address - Country:US
Practice Address - Phone:630-499-4391
Practice Address - Fax:630-499-4396
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist