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General NPI Number Information
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NPI Number | 1093302531
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Entity Type | Individual
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Provider Name | SUHA AFFANEH RPH
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Gender | Female
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 1780 WALL ST
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-5790
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Country | US
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Telephone | 888-674-7287
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Fax |
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Provider Business Mailing Address
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Address Line | 8997 BIG SABLE PT
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City | FRANKFORT
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State | IL
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Zip | 60423-1786
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Country | US
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Telephone | 708-646-8116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26028454A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.286994
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License Number State | IL
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