Provider Demographics
NPI:1154023398
Name:ALSAMARAE, ZAINAB M
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:M
Last Name:ALSAMARAE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLANCHARD CIR STE 206
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2039
Mailing Address - Country:US
Mailing Address - Phone:630-653-0848
Mailing Address - Fax:630-653-0988
Practice Address - Street 1:7 BLANCHARD CIR STE 206
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2039
Practice Address - Country:US
Practice Address - Phone:630-653-0848
Practice Address - Fax:630-653-0988
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0513054041835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care