Kevin Traser, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

051295495 Issued in IL

Practice address

327 E Jackson St
Macomb, IL 61455-2306

Phone

(309) 833-1750

Fax

(309) 837-6004

NPI assigned

Dec 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highland Park CVS LLC

  • Pharmacy
  • Macomb, IL
  • NPI 1134162514
  NPD (past)

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1053908178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552306",
            "telephone_number": "309-833-1750",
            "fax_number": "309-837-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552306",
            "telephone_number": "309-833-1750",
            "fax_number": "309-837-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "64559",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE BOARD OF PHARMACY",
            "identifier": "051295495",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Ruth Thompson, MS, RD, LDN
• Mary C Thompson, CNM
• Jessica L Thorman, FNP-C
• Bria Thurman
• Tim a Bengtson O.D., P.C.
• Trinity Speech Services LLC
• Scott Eric Urch, M.D.
• Connie Jo Ussery
• Terry Vail, O.D.
• Sherri Lynn Vancil, PT

• Pharmacist in Macomb, IL
• Providers in Macomb, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.

Verify at the official NPI Registry.