Provider Demographics
NPI:1003191701
Name:JAVED, ASIM
Entity Type:Individual
Prefix:MR
First Name:ASIM
Middle Name:
Last Name:JAVED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 HAPP RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5640
Mailing Address - Country:US
Mailing Address - Phone:847-644-2167
Mailing Address - Fax:847-368-8169
Practice Address - Street 1:1225 W DUNDEE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4009
Practice Address - Country:US
Practice Address - Phone:847-368-1998
Practice Address - Fax:847-368-8169
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051039301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist