Provider Demographics
NPI:1376220053
Name:TARIQ, ABIDA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ABIDA
Middle Name:
Last Name:TARIQ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 LIVERY CT
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2593
Mailing Address - Country:US
Mailing Address - Phone:708-717-4154
Mailing Address - Fax:773-564-9717
Practice Address - Street 1:6374 N LINCOLN AVE STE 101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1277
Practice Address - Country:US
Practice Address - Phone:773-262-6800
Practice Address - Fax:773-564-9717
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist