Provider Demographics
NPI:1649395294
Name:KAZMI, NAHEED FATIMA (PHARM, D)
Entity Type:Individual
Prefix:
First Name:NAHEED
Middle Name:FATIMA
Last Name:KAZMI
Suffix:
Gender:F
Credentials:PHARM, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 HEMLOCK LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5975
Mailing Address - Country:US
Mailing Address - Phone:630-231-1297
Mailing Address - Fax:
Practice Address - Street 1:2063 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1580
Practice Address - Country:US
Practice Address - Phone:630-584-2038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1465485OtherNCPDP
IL363168270104Medicaid
IL363168270104Medicaid