Active NPI
Jesse Neubauer
- Pharmacist
- South Elgin, IL
National Provider Identifier
1194385880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049.213726
- Practice address
- 375 Randall Rd
South Elgin, IL 60177-2248 - Phone
- (847) 608-1460
- NPI assigned
- Jun 16, 2019
- Sex
- Male
- 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 | 049.213726 | IL | Primary |
Addresses
Primary practice location
375 Randall Rd
South Elgin, IL 60177-2248
Mailing address
375 Randall Rd
South Elgin, IL 60177-2248
Phone (847) 608-1460
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 |
|---|---|---|---|
| 049.213726 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560643200000",
"number": "1194385880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 RANDALL RD",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601772248",
"telephone_number": "847-608-1460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 RANDALL RD",
"city": "SOUTH ELGIN",
"state": "IL",
"postal_code": "601772248",
"telephone_number": "847-608-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUBAUER",
"first_name": "JESSE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-16",
"last_updated": "2019-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "049.213726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.