Provider Demographics
NPI:1144502691
Name:SPERKA, CATHERINE A (RPH)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:A
Last Name:SPERKA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:A
Other - Last Name:GRESKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:13242 WICKER AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-9348
Mailing Address - Country:US
Mailing Address - Phone:219-374-9346
Mailing Address - Fax:
Practice Address - Street 1:13242 WICKER AVE
Practice Address - Street 2:
Practice Address - City:CEDAR LAKE
Practice Address - State:IN
Practice Address - Zip Code:46303-9348
Practice Address - Country:US
Practice Address - Phone:219-374-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist