Provider Demographics
NPI:1235789009
Name:HAROUN, SANAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SANAN
Middle Name:
Last Name:HAROUN
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 1:1033 PETERSON AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5184
Mailing Address - Country:US
Mailing Address - Phone:818-281-2840
Mailing Address - Fax:
Practice Address - Street 1:2955 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1555
Practice Address - Country:US
Practice Address - Phone:773-743-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist