Jalaja Puthuvalil
Individual provider Active NPI Pharmacist · Barrington, IL
NPI 1104273499 · NPPES record last updated May 17, 2016
Key facts
- NPI
- 1104273499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.288813 (IL)
- Practice address
- 150 W Main St
Barrington, IL 60010-3440 - Phone
- (847) 381-3152
- NPI assigned
- May 17, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.288813 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores LLC | Past |
Accepting new patients | |
| American Drug Stores LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.288813 | IL | Yes |
Addresses
Primary practice location
150 W Main St
Barrington, IL 60010-3440
Mailing address
150 W Main St
Barrington, IL 60010-3440
Phone (847) 381-3152
Other providers in Barrington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.