Amro Tharwat Abdel-Fattah
Individual provider Active NPI Pharmacist · Batavia, IL
NPI 1083200448 · NPPES record last updated Dec 18, 2020
Key facts
- NPI
- 1083200448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.295483 (IL)
- Practice address
- 122 W Wilson St
Batavia, IL 60510-1945 - Phone
- (630) 406-9258
- Fax
- (630) 406-1364
- NPI assigned
- Dec 18, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.295483 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
122 W Wilson St
Batavia, IL 60510
Phone (630) 406-9258
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.295483 | IL | Yes |
Addresses
Primary practice location
122 W Wilson St
Batavia, IL 60510-1945
Mailing address
122 W Wilson St
Batavia, IL 60510-1945
Phone (630) 406-9258
Other providers in Batavia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.