Provider Demographics
NPI:1528809803
Name:HUFF, CANDRA TIKARA (PHARMD)
Entity type:Individual
Prefix:
First Name:CANDRA
Middle Name:TIKARA
Last Name:HUFF
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 1:9250 JOLIET RD
Mailing Address - Street 2:
Mailing Address - City:HODGKINS
Mailing Address - State:IL
Mailing Address - Zip Code:60525-4162
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9250 JOLIET RD
Practice Address - Street 2:
Practice Address - City:HODGKINS
Practice Address - State:IL
Practice Address - Zip Code:60525-4162
Practice Address - Country:US
Practice Address - Phone:708-387-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.306223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist