Jaye Nelson

Individual provider Active NPI Pharmacy Technician · Fox Lake, IL

NPI 1164016325 · NPPES record last updated Feb 26, 2021

Key facts

NPI
1164016325
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
Practice address
61 S Route 12
Fox Lake, IL 60020-1750
Phone
(847) 587-8222
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past
since Mar 4, 2021
Accepting new patients
Walgreen Co Past
since Mar 4, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X Yes

Addresses

Primary practice location

61 S Route 12
Fox Lake, IL 60020-1750

Mailing address

3017 Pleasant Dr
McHenry, IL 60051-2636
Phone (815) 575-6867

Other providers in Fox Lake, IL

All providers in Fox Lake, IL · Pharmacy Technician in Illinois

Sources for this page

Verify at the official NPI Registry.