Provider Demographics
NPI:1609698828
Name:KOZLOWSKI, EVA M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:M
Last Name:KOZLOWSKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 ORCHARD POND CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2499
Mailing Address - Country:US
Mailing Address - Phone:773-619-7899
Mailing Address - Fax:
Practice Address - Street 1:399 S US HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-7404
Practice Address - Country:US
Practice Address - Phone:847-356-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.035375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist