Provider Demographics
NPI:1861773426
Name:SAED, LENA D (RPH)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:D
Last Name:SAED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4305
Mailing Address - Country:US
Mailing Address - Phone:847-945-0611
Mailing Address - Fax:847-945-5978
Practice Address - Street 1:780 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4305
Practice Address - Country:US
Practice Address - Phone:847-945-0611
Practice Address - Fax:847-945-5978
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-037382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL362127039045Medicaid