Individual provider Active NPI

Julie Lynn Kroenig

  • Pharmacist
  • Belleville, IL
National Provider Identifier
1164908455
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.291312 Issued in IL
Practice address
110 Carlyle Plaza Dr
Belleville, IL 62221-6678
Phone
(618) 234-8097
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2018008570 MO
Pharmacist 183500000X 051.291312 IL Primary

Addresses

Primary practice location

110 Carlyle Plaza Dr
Belleville, IL 62221-6678

Mailing address

4170 Knab Rd
Smithton, IL 62285-3524
Phone (618) 806-3342

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

LicenseStateTypeSpecialty
051.291312ILMDPharmacist
2018008570MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Schnuck Markets Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1164908455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 KNAB RD",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622853524",
            "telephone_number": "618-806-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CARLYLE PLAZA DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622216678",
            "telephone_number": "618-234-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENIG",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2018008570",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.291312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.