Provider Demographics
NPI:1477821627
Name:EKOWA, JOSEPH O (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:O
Last Name:EKOWA
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 1:13108 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-1626
Mailing Address - Country:US
Mailing Address - Phone:815-577-1039
Mailing Address - Fax:815-577-1701
Practice Address - Street 1:24801 W 135TH ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5413
Practice Address - Country:US
Practice Address - Phone:815-577-1039
Practice Address - Fax:815-577-1701
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-038449183500000X
IL051038449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist