Provider Demographics
NPI:1487254033
Name:ZURAITIS, STEFANIE (RPH)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:ZURAITIS
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 1:613 BEECH LN
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3325
Mailing Address - Country:US
Mailing Address - Phone:815-545-5353
Mailing Address - Fax:
Practice Address - Street 1:1980 FREEDOM PKWY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-9468
Practice Address - Country:US
Practice Address - Phone:309-745-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038448183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist