Provider Demographics
NPI:1558466490
Name:AVDIU, LABINOT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LABINOT
Middle Name:
Last Name:AVDIU
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 1:1830 N WINCHESTER AVE
Mailing Address - Street 2:#307
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1023
Mailing Address - Country:US
Mailing Address - Phone:312-659-1255
Mailing Address - Fax:209-580-2403
Practice Address - Street 1:3235 W 111TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2730
Practice Address - Country:US
Practice Address - Phone:773-238-6686
Practice Address - Fax:773-238-7704
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13482183500000X
WI14269183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist