Provider Demographics
NPI:1669882585
Name:LANUZA, PAMELA J (PHARMD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:LANUZA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:J
Other - Last Name:LANUZA-MALINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 S GARY AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2243
Mailing Address - Country:US
Mailing Address - Phone:630-351-7610
Mailing Address - Fax:630-351-7965
Practice Address - Street 1:130 S GARY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2243
Practice Address - Country:US
Practice Address - Phone:630-351-7610
Practice Address - Fax:630-351-7965
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.2949761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy