Provider Demographics
NPI:1972188423
Name:ZERVOS, JOANNE JANET (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:JANET
Last Name:ZERVOS
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 1:6959 157TH ST
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1019
Mailing Address - Country:US
Mailing Address - Phone:708-987-1229
Mailing Address - Fax:
Practice Address - Street 1:6227 PARK AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2636
Practice Address - Country:US
Practice Address - Phone:847-470-1818
Practice Address - Fax:855-523-0909
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051040631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist