Provider Demographics
NPI:1801195870
Name:AMIR, ASSAD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ASSAD
Middle Name:
Last Name:AMIR
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 1:500 E 51ST ST
Mailing Address - Street 2:IN-PATIENT PHARMACY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2400
Mailing Address - Country:US
Mailing Address - Phone:312-572-2413
Mailing Address - Fax:312-572-2401
Practice Address - Street 1:500 E 51ST ST
Practice Address - Street 2:IN-PATIENT PHARMACY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2400
Practice Address - Country:US
Practice Address - Phone:312-572-2413
Practice Address - Fax:312-572-2401
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-2922641835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist