Provider Demographics
NPI:1548864986
Name:JARVIS, GIOVANNI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:
Last Name:JARVIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1523
Mailing Address - Country:US
Mailing Address - Phone:773-525-0179
Mailing Address - Fax:773-877-3847
Practice Address - Street 1:2650 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1523
Practice Address - Country:US
Practice Address - Phone:773-525-0179
Practice Address - Fax:773-877-3847
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist