MEDICARE: ELIZABETH CASWELL RODGERS PHARM.D.

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
1	183500000X	Pharmacist	65402	CA
2	183500000X	Pharmacist	PD10235	AR
3	183500000X	Pharmacist	051299143	IL

General Provider Information

NPI Number	:	1316225733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CASWELL RODGERS PHARM.D.

Provider Business Mailing Address
First Line	:	20547 N MEADOW LN
Second Line	:
City	:	DEER PARK
State	:	IL
Zip	:	60010-3671
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 S EASTWOOD DR
Second Line	:	PHARMACY DEPT
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-3519
Country	:	US
Telephone Number	:	815-206-0716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2011
Last Update Date	:	05/30/2016

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