Healthcare Provider Details

I. General information

NPI: 1891607933
Provider Name (Legal Business Name): NOOR BSUL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 W 131ST ST
PALOS PARK IL
60464-1640
US

IV. Provider business mailing address

9650 W 131ST ST
PALOS PARK IL
60464-1640
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-8090
  • Fax: 708-361-3849
Mailing address:
  • Phone: 708-361-8090
  • Fax: 708-361-3849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051309528
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: