Provider Demographics
NPI:1730461880
Name:TERZIEV, THEODORE VLADIMIR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:VLADIMIR
Last Name:TERZIEV
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 1:5740 N MANTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5557
Mailing Address - Country:US
Mailing Address - Phone:773-732-1720
Mailing Address - Fax:
Practice Address - Street 1:2017 N MENDELL ST UNIT 100-B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3033
Practice Address - Country:US
Practice Address - Phone:888-428-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051288724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist