Provider Demographics
NPI:1881989432
Name:GALVAN, MORGAN CHAVEZ (PHARMD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:CHAVEZ
Last Name:GALVAN
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 1:2901 S CICERO AVE
Mailing Address - Street 2:T-0732
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-3637
Mailing Address - Country:US
Mailing Address - Phone:708-863-6833
Mailing Address - Fax:
Practice Address - Street 1:2901 S CICERO AVE
Practice Address - Street 2:T-0732
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-3637
Practice Address - Country:US
Practice Address - Phone:708-863-6833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist