Active NPI
Eugene C Blackwell Jr.
- Pharmacist
- Frankfort, IL
National Provider Identifier
1245509306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051033017
- Practice address
- 21351 Georgetown Rd
Frankfort, IL 60423-3008 - Phone
- (815) 464-0524
- NPI assigned
- Dec 19, 2011
- 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 | 051033017 | IL | Primary |
Addresses
Primary practice location
21351 Georgetown Rd
Frankfort, IL 60423-3008
Mailing address
21351 Georgetown Rd
Frankfort, IL 60423-3008
Phone (815) 464-0524
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 |
|---|---|---|---|
| 051033017 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1245509306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21351 GEORGETOWN RD",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604233008",
"telephone_number": "815-464-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21351 GEORGETOWN RD",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604233008",
"telephone_number": "815-464-0524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "EUGENE",
"middle_name": "C",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051033017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.