Provider Demographics
NPI:1831869221
Name:GORJI, NILA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NILA
Middle Name:
Last Name:GORJI
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 1:111 E CHESTNUT ST APT 23A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-6000
Mailing Address - Country:US
Mailing Address - Phone:312-520-7060
Mailing Address - Fax:
Practice Address - Street 1:933 N STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-2842
Practice Address - Country:US
Practice Address - Phone:312-943-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.304226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist