Provider Demographics
NPI:1164033700
Name:ZAMORA, KATE REENA D (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATE REENA
Middle Name:D
Last Name:ZAMORA
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 1:2191 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-6017
Mailing Address - Country:US
Mailing Address - Phone:630-668-3359
Mailing Address - Fax:630-668-3372
Practice Address - Street 1:2191 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6017
Practice Address - Country:US
Practice Address - Phone:630-668-3359
Practice Address - Fax:630-668-3372
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist