Active NPI
Stacey Jean Knuth, RPH
- Pharmacist
- Crystal Lake, IL
National Provider Identifier
1326320516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-287101
- Practice address
- 315 North Route 31
Crystal Lake, IL 60012 - Phone
- (815) 404-2643
- NPI assigned
- Sep 13, 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 | 051-287101 | IL | Primary |
Addresses
Primary practice location
315 North Route 31
Crystal Lake, IL 60012
Mailing address
10715 Shenandoah Dr
Huntley, IL 60142-6768
Phone (847) 515-3406
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-287101 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1326320516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10715 SHENANDOAH DR",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "601426768",
"telephone_number": "847-515-3406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 NORTH ROUTE 31",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60012",
"telephone_number": "815-404-2643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTH",
"first_name": "STACEY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-287101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.