Healthcare Provider Details

I. General information

NPI: 1710810551
Provider Name (Legal Business Name): DAHLIA SULTAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5758 S MARYLAND AVE
CHICAGO IL
60637-1426
US

IV. Provider business mailing address

180 HARVESTER DR STE 190
BURR RIDGE IL
60527-6693
US

V. Phone/Fax

Practice location:
  • Phone: 773-834-1912
  • Fax:
Mailing address:
  • Phone: 630-544-0980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051298986
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: