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Individual

ALEX JOHN GREGOROWICZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(502) 409-2463
Mailing address
353 N DESPLAINES ST APT 2208, CHICAGO, IL 60661-1352
(502) 409-2463

Taxonomy

Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
019213
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019213
KENTUCKY PHARMACIST LICENSE NUMBER
KY
01
051.300422
ILLINOIS PHARMACIST LICENSE NUMBER
IL
Enumeration date
08/05/2020
Last updated
08/05/2020
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