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NPI Code Detail

MEDICARE: MRS. AMINAH KHADIJAH BURNS PHARM. D.

MEDICARE: MRS. AMINAH KHADIJAH BURNS PHARM. D.
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
1183500000XPharmacist051.290835IL

General Provider Information

NPI Number : 1679850382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMINAH KHADIJAH BURNS PHARM. D.
Provider Business Mailing Address
First Line : 4800 148TH ST
Second Line :
City : MIDLOTHIAN
State : IL
Zip : 60445-3117
Country : US
Telephone Number : 708-687-1604
Fax Number : 708-687-1650
Provider Business Practice Location Address
First Line : 4800 148TH ST
Second Line :
City : MIDLOTHIAN
State : IL
Zip : 60445-3117
Country : US
Telephone Number : 708-687-1604
Fax Number : 708-687-1650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2011
Last Update Date : 11/08/2011

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