Individual provider Active NPI

Anthony Frank Adom Agyekum, RPH

  • Pharmacist
  • Benton, IL
National Provider Identifier
1154276012
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051307999 Issued in IL
Practice address
705 W Main St
Benton, IL 62812-1329
Phone
(618) 439-6356
NPI assigned
Mar 4, 2026
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051307999 IL Primary

Addresses

Primary practice location

705 W Main St
Benton, IL 62812-1329

Mailing address

705 W Main St
Benton, IL 62812-1329
Phone (618) 439-6356

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
051307999ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Park CVS, L.L.C. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1154276012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121329",
            "telephone_number": "618-439-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121329",
            "telephone_number": "618-439-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGYEKUM",
        "first_name": "ANTHONY FRANK",
        "middle_name": "ADOM",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051307999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.