Provider Demographics
NPI:1538756648
Name:KHANGURA, PAMALJIT KAUR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAMALJIT
Middle Name:KAUR
Last Name:KHANGURA
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 1:1632 ASHBURY LN
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4887
Mailing Address - Country:US
Mailing Address - Phone:847-912-7883
Mailing Address - Fax:
Practice Address - Street 1:2424 W JEFFERSON ST # AT
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6429
Practice Address - Country:US
Practice Address - Phone:815-744-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0512998901835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty