Provider Demographics
NPI:1467909234
Name:FATANI, HINNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HINNA
Middle Name:
Last Name:FATANI
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 1:1101 N PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-1051
Mailing Address - Country:US
Mailing Address - Phone:630-664-1936
Mailing Address - Fax:
Practice Address - Street 1:1101 N PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1051
Practice Address - Country:US
Practice Address - Phone:630-664-1936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist