Provider Demographics
NPI:1457519621
Name:STRUTZ, JILL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:STRUTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 N ELSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1610
Mailing Address - Country:US
Mailing Address - Phone:773-481-6962
Mailing Address - Fax:
Practice Address - Street 1:5353 N ELSTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1610
Practice Address - Country:US
Practice Address - Phone:773-481-6936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-24
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist