Provider Demographics
NPI:1275882219
Name:OSEPEK, DIANE KATHERINE (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:KATHERINE
Last Name:OSEPEK
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 BRIERGATE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2208
Mailing Address - Country:US
Mailing Address - Phone:630-983-4022
Mailing Address - Fax:
Practice Address - Street 1:1206 BRIERGATE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2208
Practice Address - Country:US
Practice Address - Phone:630-983-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051036013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist