Healthcare Provider Details

I. General information

NPI: 1093627903
Provider Name (Legal Business Name): EUNICE FOWORA PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E OGDEN AVE
WESTMONT IL
60559-1336
US

IV. Provider business mailing address

576 ALCOTT LN
BOLINGBROOK IL
60440-3525
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-8065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.308839
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: