Active NPI
Victoria T Adesina
- Pharmacist
- Evergreen Park, IL
National Provider Identifier
1235407305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051293179
- Practice address
- 8700 South Kedzie Ave
Evergreen Park, IL 60805 - Phone
- (630) 806-5340
- NPI assigned
- Dec 5, 2011
- 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 | 051293179 | IL | Primary |
Addresses
Primary practice location
8700 South Kedzie Ave
Evergreen Park, IL 60805
Mailing address
6409 Bridle Path Dr
Matteson, IL 60443-3344
Phone (630) 806-5340
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 |
|---|---|---|---|
| 051293179 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1235407305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6409 BRIDLE PATH DR",
"city": "MATTESON",
"state": "IL",
"postal_code": "604433344",
"telephone_number": "630-806-5340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 SOUTH KEDZIE AVE",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "60805",
"telephone_number": "630-806-5340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADESINA",
"first_name": "VICTORIA",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051293179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.