Active NPI
Peyton Cecilia Burke
- Pharmacist
- South Holland, IL
National Provider Identifier
1154800613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26027824A
- Practice address
- 763 E 162ND St
South Holland, IL 60473 - Phone
- (708) 339-0453
- Fax
- (708) 339-1554
- NPI assigned
- Aug 7, 2018
- Sex
- Female
- 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 | 26027824A | IN | Primary |
Addresses
Primary practice location
763 E 162ND St
South Holland, IL 60473
Mailing address
763 E 162ND St
South Holland, IL 60473-2331
Phone (708) 339-0453
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26027824A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores LLC | Past | Accepting new patients | |
| American Drug Stores LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Diamond, IL
- NPI 1013786706
-
- Community/Retail Pharmacy
- South Holland, IL
- NPI 1558317479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533600000000",
"number": "1154800613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "763 E 162ND ST",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732331",
"telephone_number": "708-339-0453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "763 E 162ND ST",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "60473",
"telephone_number": "708-339-0453",
"fax_number": "708-339-1554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "PEYTON",
"middle_name": "CECILIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2018-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26027824A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.