Edgar Auf Dem Graben

Primary specialty

Geriatric PharmacistTaxonomy code 1835G0303X

License

054-035924 Issued in IL

Practice address

100 N River Rd Ste G122
Des Plaines, IL 60016-1209

Phone

(847) 581-0800

Fax

(847) 410-4910

NPI assigned

Apr 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ascension Pharmacy Services, LLC.

  • Long Term Care Pharmacy
  • Des Plaines, IL
  • NPI 1538252184
  NPD (past) Authorized official

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1336702125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6493 N NORTHWEST HWY APT 409",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311892",
            "telephone_number": "708-774-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N RIVER RD STE G122",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161209",
            "telephone_number": "847-581-0800",
            "fax_number": "847-410-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUF DEM GRABEN",
        "first_name": "EDGAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "IL",
            "license": "054-035924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "054-035924",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eaufdemgraben@ascension.org",
            "affiliation": "Y",
            "endpointDescription": "Professional Email",
            "affiliationName": "Ascension Pharmacy Services, LLC.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N River Rd Ste G122",
            "city": "Des Plaines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600161209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Geriatric Pharmacist in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Geriatric Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.