Individual provider Active NPI

Gwendolyn J Skrezyna, RPH

  • Pharmacist
  • Joliet, IL
National Provider Identifier
1023303666
Registry record updated Jun 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-040289 Issued in IL
Practice address
2701 Plainfield Rd
T-0894
Joliet, IL 60435-1166
Phone
(815) 439-6950
Fax
(815) 439-6950
NPI assigned
Jun 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-040289 IL Primary
Pharmacist 183500000X 16469 GA

Addresses

Primary practice location

2701 Plainfield Rd
T-0894
Joliet, IL 60435-1166

Mailing address

2701 Plainfield Rd
T-0894
Joliet, IL 60435-1166
Phone (815) 439-6950

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051-040289ILMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307750400000",
    "number": "1023303666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PLAINFIELD RD",
            "address_2": "T-0894",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351166",
            "telephone_number": "815-439-6950",
            "fax_number": "815-439-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PLAINFIELD RD",
            "address_2": "T-0894",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351166",
            "telephone_number": "815-439-6950",
            "fax_number": "815-439-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKREZYNA",
        "first_name": "GWENDOLYN",
        "middle_name": "J",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-11",
        "last_updated": "2011-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-040289",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "16469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.