Individual provider Active NPI

Antoine Joseph Guillotte Sr., PHARMD

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1164133583
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.304992 Issued in IL
Practice address
101 W 87TH St
Chicago, IL 60620-1304
Phone
(773) 483-6500
NPI assigned
Dec 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.304992 IL Primary

Addresses

Primary practice location

101 W 87TH St
Chicago, IL 60620-1304

Mailing address

524 N Park Dr
Glenwood, IL 60425-1247
Phone (773) 307-8962

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aguil42@safeway.com AMERICAN DRUG STORES LLC

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

LicenseStateTypeSpecialty
051.304992ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1164133583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N PARK DR",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251247",
            "telephone_number": "773-307-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606201304",
            "telephone_number": "773-483-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOTTE",
        "first_name": "ANTOINE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.304992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aguil42@safeway.com",
            "affiliation": "Y",
            "affiliationName": "AMERICAN DRUG STORES LLC",
            "address_1": "101 W 87th St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606201304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 6, 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.

Verify at the official NPI Registry.