Individual
DR. EWA VIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
7410 N CLARK ST, CHICAGO, IL 60626-1620
(773) 743-6784
Mailing address
5821 N MULLIGAN AVE, CHICAGO, IL 60646-5332
(773) 501-2676
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-288162
IL
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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