Healthcare Provider Details

I. General information

NPI: 1487254033
Provider Name (Legal Business Name): STEFANIE ZURAITIS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2020
Last Update Date: 10/31/2020
Certification Date: 10/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 FREEDOM PKWY
WASHINGTON IL
61571-9468
US

IV. Provider business mailing address

613 BEECH LN
NEW LENOX IL
60451-3325
US

V. Phone/Fax

Practice location:
  • Phone: 309-745-3487
  • Fax:
Mailing address:
  • Phone: 815-545-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051038448
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: