Individual provider Active NPI

Charissa Balbin, PHARM D.

  • Pharmacist
  • Mundelein, IL
National Provider Identifier
1316229974
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.294210 Issued in IL
Practice address
951 N Hwy 83
Mundelein, IL 60060-9115
Phone
(847) 566-7208
NPI assigned
Sep 9, 2011
Last updated
Sep 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.294210 IL Primary

Addresses

Primary practice location

951 N Hwy 83
Mundelein, IL 60060-9115

Mailing address

1906 Brandywyn LN
Buffalo Grove, IL 60089-6688

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
051.294210ILMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1316229974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BRANDYWYN LN",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N HWY 83",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600609115",
            "telephone_number": "847-566-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBIN",
        "first_name": "CHARISSA",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.294210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.

Verify at the official NPI Registry.