Provider Demographics
NPI:1942180385
Name:ZOGAS, JELENA
Entity type:Individual
Prefix:
First Name:JELENA
Middle Name:
Last Name:ZOGAS
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 1:7644 RIDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8023
Mailing Address - Country:US
Mailing Address - Phone:773-941-1531
Mailing Address - Fax:
Practice Address - Street 1:7644 RIDGEWOOD LN
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-8023
Practice Address - Country:US
Practice Address - Phone:773-941-1531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist