Active NPI
Heather Wunderlich, CPHT
- Pharmacy Technician
- Monticello, IL
National Provider Identifier
1174957450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 049.130415
- Practice address
- 1402 N Market St
Monticello, IL 61856-8002 - Phone
- (217) 762-3377
- Fax
- (217) 762-4499
- NPI assigned
- Aug 22, 2013
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 049.130415 | IL | Primary |
Addresses
Primary practice location
1402 N Market St
Monticello, IL 61856-8002
Mailing address
1402 N Market St
Monticello, IL 61856-8002
Phone (217) 762-3377
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 |
|---|---|---|---|
| 049.130415 | IL | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirby Medical Center | Past | Accepting new patients | |
| Lynns Family Pharmacy, P.C. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377129600000",
"number": "1174957450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 N MARKET ST",
"city": "MONTICELLO",
"state": "IL",
"postal_code": "618568002",
"telephone_number": "217-762-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 N MARKET ST",
"city": "MONTICELLO",
"state": "IL",
"postal_code": "618568002",
"telephone_number": "217-762-3377",
"fax_number": "217-762-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUNDERLICH",
"first_name": "HEATHER",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-22",
"last_updated": "2013-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IL",
"license": "049.130415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.