Provider Demographics
NPI:1629679956
Name:CHAVEZ, LAURO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURO
Middle Name:
Last Name:CHAVEZ
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 1:2921 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6506
Mailing Address - Country:US
Mailing Address - Phone:773-494-9871
Mailing Address - Fax:
Practice Address - Street 1:2936 E 79TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5748
Practice Address - Country:US
Practice Address - Phone:219-942-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024292A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist