Individual provider Active NPI

Dennis Edward Nettenstrom, R.PH.

  • Pharmacist
  • Bloomingdale, IL
National Provider Identifier
1043493786
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Practice address
156 S Bloomingdale Rd
Bloomingdale, IL 60108-1472
Phone
(630) 980-9198
Fax
(630) 980-0908
NPI assigned
Dec 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Primary

Addresses

Primary practice location

156 S Bloomingdale Rd
Bloomingdale, IL 60108-1472

Mailing address

219 E Niagara Ave
Schaumburg, IL 60193-4710
Phone (847) 895-6695

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
051028553ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1043493786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E NIAGARA AVE",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601934710",
            "telephone_number": "847-895-6695",
            "fax_number": "847-895-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S BLOOMINGDALE RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081472",
            "telephone_number": "630-980-9198",
            "fax_number": "630-980-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTENSTROM",
        "first_name": "DENNIS",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.