Provider Demographics
NPI:1205672540
Name:SAID, HANI RIMON
Entity type:Individual
Prefix:
First Name:HANI
Middle Name:RIMON
Last Name:SAID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 W NORTH SHORE AVE # 1E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4311
Mailing Address - Country:US
Mailing Address - Phone:773-954-1790
Mailing Address - Fax:
Practice Address - Street 1:3019 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3726
Practice Address - Country:US
Practice Address - Phone:773-728-6254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.305916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist