Provider Demographics
NPI:1942627641
Name:RAZVI, ZAIN
Entity Type:Individual
Prefix:
First Name:ZAIN
Middle Name:
Last Name:RAZVI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17442 HARVEST HILL DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-7565
Mailing Address - Country:US
Mailing Address - Phone:773-308-5275
Mailing Address - Fax:
Practice Address - Street 1:14322 S WILL COOK RD
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-9211
Practice Address - Country:US
Practice Address - Phone:708-966-0785
Practice Address - Fax:708-405-0038
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051293839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist