Provider Demographics
NPI:1023393477
Name:LATEEF, IRAM AFZAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:IRAM
Middle Name:AFZAL
Last Name:LATEEF
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 1:2211 RILEY CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5384
Mailing Address - Country:US
Mailing Address - Phone:630-985-7266
Mailing Address - Fax:
Practice Address - Street 1:612 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9788
Practice Address - Country:US
Practice Address - Phone:630-428-9171
Practice Address - Fax:630-428-0293
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.292641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist