Provider Demographics
NPI:1831282789
Name:ALI, SYED M (RPH)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:M
Last Name:ALI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 RACQUET CLUB CT
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4917
Mailing Address - Country:US
Mailing Address - Phone:630-590-5294
Mailing Address - Fax:
Practice Address - Street 1:5TH & ROOSEVELT RD.
Practice Address - Street 2:PHARMACY SERVICE
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60414
Practice Address - Country:US
Practice Address - Phone:708-202-4765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD52111835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy