Provider Demographics
NPI:1720591787
Name:SVAZAS, LINDA M (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:SVAZAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5324
Mailing Address - Country:US
Mailing Address - Phone:630-942-1742
Mailing Address - Fax:
Practice Address - Street 1:690 E NORTH AVE STE 104
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2172
Practice Address - Country:US
Practice Address - Phone:630-933-7777
Practice Address - Fax:630-588-8403
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.0350001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist