Provider Demographics
NPI:1821426115
Name:SAJJAD, FATIHA
Entity Type:Individual
Prefix:
First Name:FATIHA
Middle Name:
Last Name:SAJJAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FATIHA
Other - Middle Name:
Other - Last Name:SIDDIQUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2248 EASTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2711
Mailing Address - Country:US
Mailing Address - Phone:847-877-0567
Mailing Address - Fax:
Practice Address - Street 1:2248 EASTVIEW DR
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2711
Practice Address - Country:US
Practice Address - Phone:847-877-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.297183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist