Provider Demographics
NPI:1649557158
Name:GADSON, ZOLLIE BENSON III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ZOLLIE
Middle Name:BENSON
Last Name:GADSON
Suffix:III
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 1:1000 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2803
Mailing Address - Country:US
Mailing Address - Phone:630-493-1567
Mailing Address - Fax:
Practice Address - Street 1:1000 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2803
Practice Address - Country:US
Practice Address - Phone:630-493-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.292003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist