Provider Demographics
NPI:1700879988
Name:ATCHA, IQBAL I (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:IQBAL
Middle Name:I
Last Name:ATCHA
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 ENGLISH OAK LN
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-3396
Mailing Address - Country:US
Mailing Address - Phone:630-965-6303
Mailing Address - Fax:
Practice Address - Street 1:118 ENGLISH OAK LN
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-3396
Practice Address - Country:US
Practice Address - Phone:630-965-6303
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist