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NPI Code Detail

MEDICARE: MRS. RUDINA N ATIEH PHARMD

MEDICARE: MRS. RUDINA N ATIEH PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051303788IL

General Provider Information

NPI Number : 1205411030
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUDINA N ATIEH PHARMD
Provider Business Mailing Address
First Line : 10602 MOODY AVE
Second Line :
City : CHICAGO RIDGE
State : IL
Zip : 60415-1926
Country : US
Telephone Number : 708-833-0808
Fax Number :
Provider Business Practice Location Address
First Line : 9500 JOLIET RD
Second Line :
City : HODGKINS
State : IL
Zip : 60525-4137
Country : US
Telephone Number : 708-387-7030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2021
Last Update Date : 03/12/2021

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