Provider Demographics
NPI:1700482981
Name:MAIERS, ROXANA MARIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:MARIA
Last Name:MAIERS
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 1:19319 BEAVER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8258
Mailing Address - Country:US
Mailing Address - Phone:815-514-5318
Mailing Address - Fax:
Practice Address - Street 1:2050 NELSON RD
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-8537
Practice Address - Country:US
Practice Address - Phone:815-463-5281
Practice Address - Fax:815-463-5286
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-287320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist