Active NPI
Scott Bevans
- Pharmacist
- Lockport, IL
National Provider Identifier
1003417809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051299782
- Practice address
- 16241 S Farrell Rd
Lockport, IL 60441-8101 - Phone
- (815) 836-3422
- NPI assigned
- Nov 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051299782 | IL | Primary |
Addresses
Primary practice location
16241 S Farrell Rd
Lockport, IL 60441-8101
Mailing address
305 S Hammes Ave
Joliet, IL 60436-1107
Phone (708) 822-8144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051299782 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1003417809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 S HAMMES AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604361107",
"telephone_number": "708-822-8144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16241 S FARRELL RD",
"city": "LOCKPORT",
"state": "IL",
"postal_code": "604418101",
"telephone_number": "815-836-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVANS",
"first_name": "SCOTT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051299782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lockport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.