Healthcare Provider Details

I. General information

NPI: 1164363099
Provider Name (Legal Business Name): MOHAMMED AWAD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

1978 WATER CHASE DR
NEW LENOX IL
60451-4818
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-7891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number051.299125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: