Provider Demographics
NPI:1871880476
Name:CHAKAN, JOHN (PHARM D)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:CHAKAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7809
Mailing Address - Country:US
Mailing Address - Phone:570-954-1999
Mailing Address - Fax:
Practice Address - Street 1:170 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7809
Practice Address - Country:US
Practice Address - Phone:570-954-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-02
Last Update Date:2011-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist