Provider Demographics
NPI:1760763700
Name:ZAKRZEWSKI, JENICE JILL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JENICE
Middle Name:JILL
Last Name:ZAKRZEWSKI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10941 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7740
Mailing Address - Country:US
Mailing Address - Phone:314-997-0555
Mailing Address - Fax:314-997-6422
Practice Address - Street 1:10941 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7740
Practice Address - Country:US
Practice Address - Phone:314-997-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003026180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist