Individual provider Active NPI

Laura Beth Urbanski, RPH

  • Pharmacist
  • Peru, IL
National Provider Identifier
1104428325
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051288037 Issued in IL
Practice address
1651 Midtown Rd
Peru, IL 61354-1267
Phone
(815) 223-4276
Fax
(815) 223-4957
NPI assigned
Nov 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051288037 IL Primary

Addresses

Primary practice location

1651 Midtown Rd
Peru, IL 61354-1267

Mailing address

65 Brook View Dr
La Salle, IL 61301-9669
Phone (815) 228-7641

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
051288037ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1104428325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BROOK VIEW DR",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613019669",
            "telephone_number": "815-228-7641",
            "fax_number": "815-223-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541267",
            "telephone_number": "815-223-4276",
            "fax_number": "815-223-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANSKI",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.