Provider Demographics
NPI:1841573557
Name:AL-HADIDI, MARIA LORETA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LORETA
Last Name:AL-HADIDI
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 1:4730 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-1350
Mailing Address - Country:US
Mailing Address - Phone:708-547-6316
Mailing Address - Fax:708-547-0019
Practice Address - Street 1:4730 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-1350
Practice Address - Country:US
Practice Address - Phone:708-547-6316
Practice Address - Fax:708-547-0019
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-289388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist