Provider Demographics
NPI:1346966108
Name:DUDZINSKI, JUDY MARIE I (RPH)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIE
Last Name:DUDZINSKI
Suffix:I
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2736
Mailing Address - Country:US
Mailing Address - Phone:630-617-2835
Mailing Address - Fax:630-617-2836
Practice Address - Street 1:110 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2736
Practice Address - Country:US
Practice Address - Phone:630-617-2835
Practice Address - Fax:630-617-2083
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-034363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist