Healthcare Provider Details

I. General information

NPI: 1255246237
Provider Name (Legal Business Name): YASIR ISAM HAMAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16701 HARLEM AVE
TINLEY PARK IL
60477-2733
US

IV. Provider business mailing address

16701 HARLEM AVE
TINLEY PARK IL
60477-2733
US

V. Phone/Fax

Practice location:
  • Phone: 708-444-4256
  • Fax:
Mailing address:
  • Phone: 708-444-4256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051309260
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: