Provider Demographics
NPI:1770374043
Name:ALESHINA, MARIIA
Entity type:Individual
Prefix:
First Name:MARIIA
Middle Name:
Last Name:ALESHINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WIGWAM HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:IL
Mailing Address - Zip Code:61455-4143
Mailing Address - Country:US
Mailing Address - Phone:415-734-1098
Mailing Address - Fax:
Practice Address - Street 1:327 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:IL
Practice Address - Zip Code:61455-2306
Practice Address - Country:US
Practice Address - Phone:309-833-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL049.311762183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician