Provider Demographics
NPI:1306345855
Name:HAIDER, AMINA (OD)
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:
Last Name:HAIDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 ARLINGTON DR W
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-5561
Mailing Address - Country:US
Mailing Address - Phone:630-744-9220
Mailing Address - Fax:
Practice Address - Street 1:102 STRATFORD SQUARE MALL
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2202
Practice Address - Country:US
Practice Address - Phone:630-893-7608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011147152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist