Most Relevant Information
Provider Data
| NPI Number: | 1003047630 |
| Provider Name: | NISHA MEHTA |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051293490 |
Most Important Dates
| Enumeration Date: | 07/30/2009 |
| Last Updated: | 12/08/2011 |
Provider Practice Location
820 S DAMEN AVE
PHARMACY (119)
CHICAGO
IL
606123728
Practice Location Phone/Fax
| Phone: | 3125695906 |
| Fax: |
Provider Mailing Location
820 S DAMEN AVE
PHARMACY (119)
CHICAGO
IL
606123728
Provider Mailing Phone/Fax
| Phone: | 3125695906 |
| Fax: |