Provider Demographics
NPI:1770932493
Name:HOLZE, JANE (PHARM D)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:HOLZE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3101
Mailing Address - Country:US
Mailing Address - Phone:847-255-8754
Mailing Address - Fax:847-255-4710
Practice Address - Street 1:442 E RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3101
Practice Address - Country:US
Practice Address - Phone:847-255-8754
Practice Address - Fax:847-255-4710
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.289551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist