Provider Demographics
NPI:1851090195
Name:AWADALLAH, HAMZA (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:HAMZA
Middle Name:
Last Name:AWADALLAH
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11164 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-2709
Mailing Address - Country:US
Mailing Address - Phone:708-541-1000
Mailing Address - Fax:708-666-8112
Practice Address - Street 1:11164 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2709
Practice Address - Country:US
Practice Address - Phone:708-541-1000
Practice Address - Fax:708-666-8112
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist