Individual provider Active NPI

Theresa Lynn Brehm, PHARMD

  • Pharmacist
  • Galena, IL
National Provider Identifier
1265057137
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051299682 Issued in IL
Practice address
11002 Bartel Blvd
Galena, IL 61036-8215
Phone
(815) 777-2700
Fax
(815) 777-4265
NPI assigned
Jun 16, 2020
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051299682 IL Primary

Addresses

Primary practice location

11002 Bartel Blvd
Galena, IL 61036-8215

Mailing address

11002 Bartel Blvd
Galena, IL 61036-8215
Phone (815) 777-2700

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051299682ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartig Drug Co Corp PastSince Jun 21, 2020 Accepting new patients
Hartig Drug Co Corp PastSince Jun 21, 2020 Accepting new patients

Organizations & group practices 2

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1265057137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11002 BARTEL BLVD",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368215",
            "telephone_number": "815-777-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11002 BARTEL BLVD",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368215",
            "telephone_number": "815-777-2700",
            "fax_number": "815-777-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREHM",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051299682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.