Provider Demographics
NPI:1528349883
Name:RAHEJA, GEETIKA
Entity type:Individual
Prefix:DR
First Name:GEETIKA
Middle Name:
Last Name:RAHEJA
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 1:225 N COLUMBUS DR
Mailing Address - Street 2:APT#3609
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7910
Mailing Address - Country:US
Mailing Address - Phone:815-670-5040
Mailing Address - Fax:
Practice Address - Street 1:1001 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3302
Practice Address - Country:US
Practice Address - Phone:773-477-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist