Individual
MELISA BLAZEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2112 W PETERSON AVE, CHICAGO, IL 60659-4277
(773) 761-3006
Mailing address
2112 W PETERSON AVE, CHICAGO, IL 60659-4277
(773) 761-3006
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049.225292
IL
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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