Candice Marie Faller, PHARMD.
Individual provider Active NPI Pharmacist · Anna, IL
NPI 1306222658 · NPPES record last updated Nov 7, 2024
Key facts
- NPI
- 1306222658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051299861 (IL)
- Practice address
- 300 Leigh Ave
Anna, IL 62906-2213 - Phone
- (618) 833-8580
- NPI assigned
- Aug 9, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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 |
|---|---|---|---|
| 051299861 | IL | MD | Pharmacist |
| 56901 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients | |
| Walmart Inc. | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 56901 | TX | |
| Pharmacist | 183500000X | 051299861 | IL | Yes |
Addresses
Primary practice location
300 Leigh Ave
Anna, IL 62906-2213
Mailing address
300 Leigh Ave
Anna, IL 62906-2213
Phone (618) 833-8580
Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2024. 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.