Provider Demographics
NPI:1477804532
Name:RAHMAN, KHALIL (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KHALIL
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 READING ST
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4558
Mailing Address - Country:US
Mailing Address - Phone:630-501-8216
Mailing Address - Fax:630-823-7515
Practice Address - Street 1:969 READING ST
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4558
Practice Address - Country:US
Practice Address - Phone:630-501-8216
Practice Address - Fax:630-823-7515
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051037376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist