Provider Demographics
NPI:1083991434
Name:SPANOS, MARIA E (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:SPANOS
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 1:441 W MELROSE ST
Mailing Address - Street 2:UNIT 1C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3845
Mailing Address - Country:US
Mailing Address - Phone:219-793-3193
Mailing Address - Fax:
Practice Address - Street 1:441 W MELROSE ST
Practice Address - Street 2:UNIT 1C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3845
Practice Address - Country:US
Practice Address - Phone:219-793-3193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist