Active NPI
Johanna Visa
- Pharmacist
- Chicago, IL
National Provider Identifier
1336598341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051297571
- Practice address
- 5516 N Clark St
Chicago, IL 60640-1214 - Phone
- (773) 784-7348
- Fax
- (773) 784-1408
- NPI assigned
- Jun 9, 2016
- 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 | 051297571 | IL | Primary |
Addresses
Primary practice location
5516 N Clark St
Chicago, IL 60640-1214
Mailing address
5532 Clark Street
Chicago, IL 60640
Phone (773) 784-7348
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 |
|---|---|---|---|
| 051297571 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores LLC | Past | Accepting new patients | |
| American Drug Stores LLC | Past | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Diamond, IL
- NPI 1013786706
-
- Community/Retail Pharmacy
- Chicago, IL
- NPI 1992743132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465430400000",
"number": "1336598341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5532 CLARK STREET",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60640",
"telephone_number": "773-784-7348",
"fax_number": "773-784-1408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5516 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606401214",
"telephone_number": "773-784-7348",
"fax_number": "773-784-1408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISA",
"first_name": "JOHANNA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-09",
"last_updated": "2016-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051297571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.