Provider Demographics
NPI:1336769074
Name:AHMED, SHAKEEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAKEEL
Middle Name:
Last Name:AHMED
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 1:234 LILLIAN PL
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-2315
Mailing Address - Country:US
Mailing Address - Phone:773-968-9439
Mailing Address - Fax:
Practice Address - Street 1:1471 E BUSINESS CENTER DR STE 500
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6082
Practice Address - Country:US
Practice Address - Phone:847-553-2616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.2891631835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist