Provider Demographics
NPI:1881351021
Name:NIYRAA LLC
Entity type:Organization
Organization Name:NIYRAA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:QUADRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-310-7729
Mailing Address - Street 1:741 S MCHENRY AVE STE E
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7445
Mailing Address - Country:US
Mailing Address - Phone:815-701-1033
Mailing Address - Fax:
Practice Address - Street 1:741 S MCHENRY AVE STE E
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7445
Practice Address - Country:US
Practice Address - Phone:815-701-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No333600000XSuppliersPharmacy
Yes291U00000XLaboratoriesClinical Medical Laboratory