NPI 1013390202

Everardo Jesus Mojica, PHARMD

Practitioner Pharmacy Technician Chicago, IL

Practice location

Address: 6525 W Diversey Ave, Chicago, IL 60707-2312
Phone: (773) 804-3611
Mailing address: 3722 W Giddings St, Chicago, IL 60625-5739

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 049.201057 (IL)

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Registry record

NPI: 1013390202
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jul 2015
Record last updated: 7 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.