Individual provider Active NPI

Jaimie M Szczecinski

  • Pharmacist
  • Tinley Park, IL
National Provider Identifier
1104438910
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.299817 Issued in IL
Practice address
8400 171St St
Tinley Park, IL 60487-2287
Phone
(708) 429-3324
Fax
(708) 429-0996
NPI assigned
Aug 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 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 051.299817 IL Primary

Addresses

Primary practice location

8400 171St St
Tinley Park, IL 60487-2287

Mailing address

8400 171St St
Tinley Park, IL 60487-2287
Phone (708) 429-3324

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

LicenseStateTypeSpecialty
051.299817ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1104438910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 171ST ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604872287",
            "telephone_number": "708-429-3324",
            "fax_number": "708-429-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 171ST ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604872287",
            "telephone_number": "708-429-3324",
            "fax_number": "708-429-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZCZECINSKI",
        "first_name": "JAIMIE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.299817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.