Provider Demographics
NPI:1407443476
Name:MILWAY, EVAN JOHN (PHARMD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:JOHN
Last Name:MILWAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 S DELANO CT E APT 405E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3451
Mailing Address - Country:US
Mailing Address - Phone:908-566-2101
Mailing Address - Fax:
Practice Address - Street 1:10 E 81ST AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5550
Practice Address - Country:US
Practice Address - Phone:219-769-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029099A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist