Provider Demographics
NPI:1265087811
Name:ATIEH, NADER (PHARMD)
Entity type:Individual
Prefix:
First Name:NADER
Middle Name:
Last Name:ATIEH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1821
Mailing Address - Country:US
Mailing Address - Phone:708-598-0505
Mailing Address - Fax:708-598-0606
Practice Address - Street 1:7261 W 87TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-1821
Practice Address - Country:US
Practice Address - Phone:708-598-0505
Practice Address - Fax:708-598-0606
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051289092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist