MEDICARE: ABIDA TARIQ PHARMACIST

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
1	183500000X	Pharmacist	051038466	IL

General Provider Information

NPI Number	:	1376220053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIDA TARIQ PHARMACIST

Provider Business Mailing Address
First Line	:	91 LIVERY CT
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-2593
Country	:	US
Telephone Number	:	708-717-4154
Fax Number	:	773-564-9717

Provider Business Practice Location Address
First Line	:	6374 N LINCOLN AVE STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1277
Country	:	US
Telephone Number	:	773-262-6800
Fax Number	:	773-564-9717

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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Directions to “ ABIDA TARIQ PHARMACIST” Practice Location

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