Individual
DR. FADE KHALEQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 W 144TH ST, RIVERDALE, IL 60827-2733
(708) 849-5512
Mailing address
250 W 144TH ST, RIVERDALE, IL 60827-2733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051301758
IL
Other
Enumeration date
12/25/2020
Last updated
12/25/2020
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