Provider Demographics
NPI:1083203020
Name:ROZYCKI, NATALIE MARIE (RPH)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:MARIE
Last Name:ROZYCKI
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 1:883 BRISTOL LN
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9226
Mailing Address - Country:US
Mailing Address - Phone:708-945-7682
Mailing Address - Fax:
Practice Address - Street 1:2375 DRAUDEN ROAD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60434
Practice Address - Country:US
Practice Address - Phone:815-577-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051295873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist