Provider Demographics
NPI:1497960405
Name:DJURIC, MARLOWE MEGAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARLOWE
Middle Name:MEGAN
Last Name:DJURIC
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 1:722 W MAXWELL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-5002
Mailing Address - Country:US
Mailing Address - Phone:312-355-2405
Mailing Address - Fax:312-413-3727
Practice Address - Street 1:722 W MAXWELL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-5002
Practice Address - Country:US
Practice Address - Phone:312-355-2405
Practice Address - Fax:312-413-3727
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-290691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist