Jola Burnazi, PHARMD
Individual provider Active NPI Pharmacist · River Forest, IL
NPI 1497420475 · NPPES record last updated Aug 12, 2021
Key facts
- NPI
- 1497420475
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051304089 (IL)
- Practice address
- 7251 Lake St
River Forest, IL 60305-2238 - Phone
- (708) 366-9960
- NPI assigned
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051304089 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051304089 | IL | Yes |
Addresses
Primary practice location
7251 Lake St
River Forest, IL 60305-2238
Mailing address
2000 N 76TH CT
Elmwood Park, IL 60707-3610
Phone (708) 928-1382
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B65242094674 | Other | DRIVERS LICENSE |
Other providers in River Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.