Abdul Moyeed Atif, PHARMD
Individual provider Active NPI Pharmacist · Mendota, IL
NPI 1083353395 · NPPES record last updated Jun 3, 2022
Key facts
- NPI
- 1083353395
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 049304037 (IL)
- Practice address
- 1212 13TH Ave
Mendota, IL 61342-1411 - Phone
- (815) 538-2095
- Fax
- (815) 538-4050
- NPI assigned
- Jun 3, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049304037 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 049304037 | IL | Yes |
Addresses
Primary practice location
1212 13TH Ave
Mendota, IL 61342-1411
Mailing address
1212 13TH Ave
Mendota, IL 61342-1411
Phone (815) 538-2095
Other providers in Mendota, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2022. 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.