Provider Demographics
NPI:1528632361
Name:ALCHAAR, MOHAMMED
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:ALCHAAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10995 116TH AVE UNIT 206
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1825
Mailing Address - Country:US
Mailing Address - Phone:262-748-5404
Mailing Address - Fax:
Practice Address - Street 1:2100 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-2327
Practice Address - Country:US
Practice Address - Phone:262-748-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.303859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist