=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578358768
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEJANDRA CAZARES PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2025
-----------------------------------------------------
Last Update Date | 04/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1401 E STATE ST
-----------------------------------------------------
City | ROCKFORD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61104-2315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 779-696-1130
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35W275 CRESCENT DR
-----------------------------------------------------
City | DUNDEE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60118-9310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-242-0993
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 051.306504
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------