Provider Demographics
NPI:1013661891
Name:RAHMAN, AAKIFA I (PHARMD)
Entity Type:Individual
Prefix:
First Name:AAKIFA
Middle Name:
Last Name:RAHMAN
Suffix:I
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 1:9 LEASIDE CT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4029
Mailing Address - Country:US
Mailing Address - Phone:314-620-7773
Mailing Address - Fax:
Practice Address - Street 1:2610 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-1251
Practice Address - Country:US
Practice Address - Phone:217-352-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.304591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist