Beau Blumenschein, PHARM.D.
Individual provider Active NPI Pharmacist · Antioch, IL
NPI 1205430360 · NPPES record last updated Nov 29, 2020
Key facts
- NPI
- 1205430360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.298744 (IL)
- Practice address
- 983 Il Route 59
Antioch, IL 60002-1453 - Phone
- (847) 395-5691
- Fax
- (847) 395-5894
- NPI assigned
- Nov 29, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.298744 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Park CVS, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.298744 | IL | Yes |
Addresses
Primary practice location
983 Il Route 59
Antioch, IL 60002-1453
Mailing address
983 Il Route 59
Antioch, IL 60002-1453
Phone (847) 395-5691
Other providers in Antioch, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.