Active NPI
Matthew Regan
- Pharmacist
- Antioch, IL
National Provider Identifier
1336736198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051040672
- Practice address
- 983 Il Route 59
Antioch, IL 60002-1453 - Phone
- (847) 395-5691
- NPI assigned
- Dec 28, 2020
- Sex
- Male
- 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 | 051040672 | IL | Primary |
Addresses
Primary practice location
983 Il Route 59
Antioch, IL 60002-1453
Mailing address
171 N Pioneer Dr
Addison, IL 60101-2164
Phone (630) 302-6464
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 |
|---|---|---|---|
| 051040672 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Park CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Antioch, IL
- NPI 1871729988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609113600000",
"number": "1336736198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 N PIONEER DR",
"city": "ADDISON",
"state": "IL",
"postal_code": "601012164",
"telephone_number": "630-302-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "983 IL ROUTE 59",
"city": "ANTIOCH",
"state": "IL",
"postal_code": "600021453",
"telephone_number": "847-395-5691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGAN",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-28",
"last_updated": "2020-12-28",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051040672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.