Provider Demographics
NPI:1326163973
Name:VARGHESE, MAREENA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAREENA
Middle Name:
Last Name:VARGHESE
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 1:2000 S RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4490
Mailing Address - Country:US
Mailing Address - Phone:630-208-8936
Mailing Address - Fax:630-208-8615
Practice Address - Street 1:2000 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4490
Practice Address - Country:US
Practice Address - Phone:630-208-8936
Practice Address - Fax:630-208-8615
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist