Individual provider · NPI-1

Wisam Abdallah

Pharmacist · Chicago, IL

NPI number1801676804
StatusActive
Last updated in NPPESOct 5, 2023

Details

NPI
1801676804
Entity type
Individual (NPI-1)
Name
Wisam Abdallah
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 5, 2023
Certification date
Oct 5, 2023
Last updated
Oct 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist051304082ILYes

Practice location

1629 S Prairie Ave Unit 2104
Chicago, IL 60616-5065

Phone 708-837-1233

Mailing address

11164 Southwest Hwy
Palos Hills, IL 60465-2709

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