Peter Nanos – Pharmacist in Carol Stream, IL

Key facts

NPI: 1154737260
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 051031719 (IL)
Practice address: 1165 Brookstone Dr
Carol Stream, IL 60188-3341
Phone: (630) 231-0874
NPI assigned: Jul 9, 2014
Sex: Male
Sole proprietor: Yes

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
051031719	IL	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	051031719	IL	Yes

Addresses

Primary practice location

1165 Brookstone Dr
Carol Stream, IL 60188-3341

Mailing address

1165 Brookstone Dr
Carol Stream, IL 60188-3341

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2014.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1154737260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 BROOKSTONE DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 BROOKSTONE DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883341",
            "telephone_number": "630-231-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANOS",
        "first_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051031719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

All providers in Carol Stream, IL · Pharmacist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2014. 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.

Verify at the official NPI Registry.