Active NPI
Maribel Thiebaud, PHARM D.
- Pharmacist
- Chicago, IL
National Provider Identifier
1194150912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.296911
- Practice address
- 1601 N Wells St
Chicago, IL 60614-6001 - Phone
- (312) 642-4008
- NPI assigned
- Sep 11, 2013
- Last updated
- Sep 11, 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.296911 | IL | Primary |
Addresses
Primary practice location
1601 N Wells St
Chicago, IL 60614-6001
Mailing address
2400 N Lakeview Ave Apt 810
Chicago, IL 60614-2734
Phone (989) 980-0083
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051.296911 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1194150912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 N LAKEVIEW AVE APT 810",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606142734",
"telephone_number": "989-980-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 N WELLS ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606146001",
"telephone_number": "312-642-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEBAUD",
"first_name": "MARIBEL",
"name_prefix": "Miss",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-11",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.296911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Sep 11, 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.