Provider Demographics
NPI:1780855874
Name:YOUKHANA, ALBERT K (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:K
Last Name:YOUKHANA
Suffix:
Gender:M
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 1:9301 MARMORA AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1511
Mailing Address - Country:US
Mailing Address - Phone:847-965-1615
Mailing Address - Fax:
Practice Address - Street 1:9301 MARMORA AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1511
Practice Address - Country:US
Practice Address - Phone:708-786-7820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist