Healthcare Provider Details

I. General information

NPI: 1730098203
Provider Name (Legal Business Name): AHMAD RAHMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 JANES AVE
WOODRIDGE IL
60517-2303
US

IV. Provider business mailing address

14531 RENMORE RD
HOMER GLEN IL
60491-9412
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.309071
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: