Provider Demographics
NPI:1568062800
Name:MAJERCZAK, ANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MAJERCZAK
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 1:6570 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1621
Mailing Address - Country:US
Mailing Address - Phone:847-855-8621
Mailing Address - Fax:
Practice Address - Street 1:6570 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-1621
Practice Address - Country:US
Practice Address - Phone:847-855-8621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20212-40183500000X
IL051.302683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist