Provider Demographics
NPI:1740565787
Name:ZERAZION, BINIAM T (RPH)
Entity Type:Individual
Prefix:DR
First Name:BINIAM
Middle Name:T
Last Name:ZERAZION
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 FLORENCE WAY
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5630
Mailing Address - Country:US
Mailing Address - Phone:773-744-2498
Mailing Address - Fax:
Practice Address - Street 1:1546 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-1259
Practice Address - Country:US
Practice Address - Phone:773-622-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051292281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist