Healthcare Provider Details

I. General information

NPI: 1265085401
Provider Name (Legal Business Name): SANA SAQLAIN PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10204 WERCH DR STE 302
WOODRIDGE IL
60517
US

IV. Provider business mailing address

10204 WERCH DR STE 302
WOODRIDGE IL
60517
US

V. Phone/Fax

Practice location:
  • Phone: 877-622-6633
  • Fax: 877-662-6355
Mailing address:
  • Phone: 877-622-6633
  • Fax: 877-662-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051297907
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: