Provider Demographics
NPI:1205425626
Name:ALZEIN, DEMA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEMA
Middle Name:
Last Name:ALZEIN
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 1:4 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5760
Mailing Address - Country:US
Mailing Address - Phone:708-955-4933
Mailing Address - Fax:
Practice Address - Street 1:6700 W 95TH ST STE 150
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2280
Practice Address - Country:US
Practice Address - Phone:708-598-5000
Practice Address - Fax:708-598-6737
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist