Provider Demographics
NPI:1609159052
Name:ROZENBLAT, ANNA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ROZENBLAT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5266
Mailing Address - Country:US
Mailing Address - Phone:847-502-6262
Mailing Address - Fax:
Practice Address - Street 1:900 DODGE AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1507
Practice Address - Country:US
Practice Address - Phone:847-475-7218
Practice Address - Fax:847-475-7957
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.291933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist