Individual provider Active NPI

Dianna Christina Ciardullo, RPH

  • Pharmacist
  • Glen Ellyn, IL
National Provider Identifier
1205283397
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051287591 Issued in IL
Practice address
599 E Roosevelt Road
Glen Ellyn, IL 60137
Phone
(630) 790-2295
Fax
(630) 790-3124
NPI assigned
May 18, 2016
Last updated
May 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051287591 IL Primary

Addresses

Primary practice location

599 E Roosevelt Road
Glen Ellyn, IL 60137

Mailing address

599 E Roosevelt Road
Glen Ellyn, IL 60137
Phone (630) 790-2295

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051287591ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
American Drug Stores LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1205283397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 E ROOSEVELT ROAD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-790-2295",
            "fax_number": "630-790-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 E ROOSEVELT ROAD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-790-2295",
            "fax_number": "630-790-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARDULLO",
        "first_name": "DIANNA",
        "middle_name": "CHRISTINA",
        "name_prefix": "Miss",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051287591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.