Provider Demographics
NPI:1437502812
Name:VARDA, JOSEPHINE KOCHOU (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:KOCHOU
Last Name:VARDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:
Other - Last Name:KOCHOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5145 N CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3661
Mailing Address - Country:US
Mailing Address - Phone:773-293-8525
Mailing Address - Fax:773-506-0085
Practice Address - Street 1:5145 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3661
Practice Address - Country:US
Practice Address - Phone:773-293-8525
Practice Address - Fax:773-506-0085
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.299540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist