Provider Demographics
NPI:1225305410
Name:SOLAVA, MEAGAN RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:RYAN
Last Name:SOLAVA
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 1:1831 HARVARD LN
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3805
Mailing Address - Country:US
Mailing Address - Phone:815-485-5035
Mailing Address - Fax:
Practice Address - Street 1:450 S SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-2080
Practice Address - Country:US
Practice Address - Phone:815-485-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.295276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist