Active NPI
Jaison Joseph
- Pharmacist
- Washington, IL
National Provider Identifier
1083049878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051297067
- Practice address
- 1101 Peoria St
Washington, IL 61571-2350 - Phone
- (309) 444-1681
- NPI assigned
- Sep 11, 2013
- Last updated
- Sep 11, 2013
- 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 | 051297067 | IL | Primary |
Addresses
Primary practice location
1101 Peoria St
Washington, IL 61571-2350
Mailing address
2711 Maynard Dr
Glenview, IL 60025-4679
Phone (847) 890-2055
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 |
|---|---|---|---|
| 051297067 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1083049878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2711 MAYNARD DR",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600254679",
"telephone_number": "847-890-2055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 PEORIA ST",
"city": "WASHINGTON",
"state": "IL",
"postal_code": "615712350",
"telephone_number": "309-444-1681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "JAISON",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-11",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051297067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.