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NPI Code Detail

MEDICARE: EDWARD SCOTT LOZANO PHARMD

MEDICARE:   EDWARD SCOTT LOZANO  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835N1003XNutrition Support Pharmacist051032369IL
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist051032369IL

General Provider Information

NPI Number : 1063877611
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD SCOTT LOZANO PHARMD
Provider Business Mailing Address
First Line : 2571 SUN VALLEY RD
Second Line :
City : LISLE
State : IL
Zip : 60532-3434
Country : US
Telephone Number : 630-251-2307
Fax Number : 773-792-5038
Provider Business Practice Location Address
First Line : 5841 SOUTH MARYLAND AVE
Second Line : UNIVERSITY OF CHICAGO
City : CHICAGO
State : IL
Zip : 60637-1465
Country : US
Telephone Number : 773-834-2879
Fax Number : 773-702-6972
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2015
Last Update Date : 12/28/2015

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