Active NPI
Timothy Walsh, PHARMD
- Pharmacist
- Chicago, IL
National Provider Identifier
1104549062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.304059
- Practice address
- 678 N Wells St
Chicago, IL 60654-3717 - Phone
- (312) 255-0425
- NPI assigned
- Sep 26, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 051.304059 | IL | Primary |
Addresses
Primary practice location
678 N Wells St
Chicago, IL 60654-3717
Mailing address
220 W Illinois St Unit 1704
Chicago, IL 60654-4642
Phone (414) 405-9651
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.304059 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Park CVS LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1104549062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W ILLINOIS ST UNIT 1704",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544642",
"telephone_number": "414-405-9651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "678 N WELLS ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606543717",
"telephone_number": "312-255-0425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "TIMOTHY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-26",
"last_updated": "2022-09-26",
"certification_date": "2022-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.304059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.