Provider Demographics
NPI:1619261864
Name:HAIDER, SYED NAUMAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:NAUMAN
Last Name:HAIDER
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 1:1800 ORCHARD GATEWAY BLVD
Mailing Address - Street 2:T-2177
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-6500
Mailing Address - Country:US
Mailing Address - Phone:630-518-9043
Mailing Address - Fax:630-518-9043
Practice Address - Street 1:1800 ORCHARD GATEWAY BLVD
Practice Address - Street 2:T-2177
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-6500
Practice Address - Country:US
Practice Address - Phone:630-518-9043
Practice Address - Fax:630-518-9043
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293493183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist