Provider Demographics
NPI:1811577331
Name:GALAL, AUDREY NADIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:NADIA
Last Name:GALAL
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 1:3200 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-4031
Mailing Address - Country:US
Mailing Address - Phone:773-890-1800
Mailing Address - Fax:
Practice Address - Street 1:3200 W 26TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4031
Practice Address - Country:US
Practice Address - Phone:773-890-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51298428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist