Provider Demographics
NPI:1982938577
Name:GANDHI, RAJUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAJUL
Middle Name:
Last Name:GANDHI
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 1:2402 VILLAGE GREEN PLACE
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-3512
Mailing Address - Country:US
Mailing Address - Phone:217-398-2764
Mailing Address - Fax:217-398-4009
Practice Address - Street 1:2402 VILLAGE GREEN PLACE
Practice Address - Street 2:WALGREENS PHARMACY
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-3512
Practice Address - Country:US
Practice Address - Phone:217-398-2764
Practice Address - Fax:217-398-4009
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist