Individual
DR. JOLA BURNAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7251 LAKE ST, RIVER FOREST, IL 60305-2238
(708) 366-9960
Mailing address
2000 N 76TH CT, ELMWOOD PARK, IL 60707-3610
(708) 928-1382
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051304089
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B65242094674
DRIVERS LICENSE
—
Enumeration date
08/12/2021
Last updated
08/12/2021
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