Provider Demographics
NPI:1700088259
Name:GOZDZIAK, ELIZABETH IRENE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:IRENE
Last Name:GOZDZIAK
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 1:4927 NORTHCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3434
Mailing Address - Country:US
Mailing Address - Phone:630-271-1731
Mailing Address - Fax:
Practice Address - Street 1:942 S YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5115
Practice Address - Country:US
Practice Address - Phone:630-834-2000
Practice Address - Fax:630-834-0238
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist