Provider Demographics
NPI:1386984706
Name:JOZWIAK, DOROTA (PHARMD)
Entity type:Individual
Prefix:
First Name:DOROTA
Middle Name:
Last Name:JOZWIAK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22W010 SPRING VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MEDINAH
Mailing Address - State:IL
Mailing Address - Zip Code:60157-9755
Mailing Address - Country:US
Mailing Address - Phone:630-671-1458
Mailing Address - Fax:
Practice Address - Street 1:625 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5240
Practice Address - Country:US
Practice Address - Phone:630-690-6474
Practice Address - Fax:630-690-6567
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051286851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist