Provider Demographics
NPI:1912293945
Name:MUNEERUDDIN, AZEEZA UNNISA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:AZEEZA
Middle Name:UNNISA
Last Name:MUNEERUDDIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 W TOUHY AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4621
Mailing Address - Country:US
Mailing Address - Phone:847-588-2808
Mailing Address - Fax:847-588-2808
Practice Address - Street 1:6150 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4621
Practice Address - Country:US
Practice Address - Phone:847-588-2808
Practice Address - Fax:847-588-2808
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist