Provider Demographics
NPI:1679165765
Name:ROSTOVSKA, YEVHENIYA (PHARMB)
Entity type:Individual
Prefix:
First Name:YEVHENIYA
Middle Name:
Last Name:ROSTOVSKA
Suffix:
Gender:F
Credentials:PHARMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 S MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-3108
Mailing Address - Country:US
Mailing Address - Phone:847-459-0001
Mailing Address - Fax:
Practice Address - Street 1:56 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-3108
Practice Address - Country:US
Practice Address - Phone:847-459-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051297492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist