Dale Suhrenbrock, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.031813 Issued in IL

Practice address

1122 Vaughn Rd
Wood River, IL 62095-1848

Phone

(618) 259-2013

Fax

(618) 259-2098

NPI assigned

Sep 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1104109800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CHANCELLOR DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253936",
            "telephone_number": "618-830-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 VAUGHN RD",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951848",
            "telephone_number": "618-259-2013",
            "fax_number": "618-259-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUHRENBROCK",
        "first_name": "DALE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.031813",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "029774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart Worland Smith III, D.C.
• Claud R Snowden, OD
• Southern Illinois Treatment Center, LLC (MedMark Treatment Centers Wood River)
• Kathleen Rose Steiner, RN
• Madge Strohmeier, SLP
• Mary Svec, MS, CCC-A/SLP
• Madisyn Taylor Swift
• Angela Leigh Szymarek, DT
• Michelle Talbott
• The Listening Loft PLLC

• Pharmacist in Wood River, IL
• Providers in Wood River, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.