Provider Demographics
NPI:1578840666
Name:SHALABI, NESRIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NESRIN
Middle Name:
Last Name:SHALABI
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 1:8715 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1905
Mailing Address - Country:US
Mailing Address - Phone:708-598-2511
Mailing Address - Fax:708-598-2174
Practice Address - Street 1:4353 W 78TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1220
Practice Address - Country:US
Practice Address - Phone:773-612-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051291262183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist