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General NPI Number Information
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NPI Number | 1134880768
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Entity Type | Organization
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Legal Business Name | COVID TESTING OF ORLAND
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 15250 ORLAN BROOK DR
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City | ORLAND PARK
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State | IL
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Zip | 60462-3938
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Country | US
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Telephone | 708-262-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 15250 ORLAN BROOK DR
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City | ORLAND PARK
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State | IL
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Zip | 60462-3938
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Country | US
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Telephone | 708-262-4609
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FUAD ABDELJABER
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Credential | PHARMD
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Telephone | 708-262-4609
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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 |
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License Number State |
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