Provider Demographics
NPI:1902187271
Name:BARBARAWI, AMAL M (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:M
Last Name:BARBARAWI
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 1:4740 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2530
Mailing Address - Country:US
Mailing Address - Phone:708-425-6960
Mailing Address - Fax:708-425-9543
Practice Address - Street 1:4740 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2530
Practice Address - Country:US
Practice Address - Phone:708-425-6960
Practice Address - Fax:708-425-9543
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-292996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist