Healthcare Provider Details

I. General information

NPI: 1861328502
Provider Name (Legal Business Name): SAKINA SYEDA QUADRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 W JEFFERSON ST
JOLIET IL
60435-6858
US

IV. Provider business mailing address

1163 W JEFFERSON ST
JOLIET IL
60435-6858
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-4002
  • Fax: 815-744-0197
Mailing address:
  • Phone: 815-744-4002
  • Fax: 815-744-0197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051308593
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: