Active NPI
Dale A Wszalek
- Pharmacist
- Waupun, WI
National Provider Identifier
1356628564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- WI11142-040
- Practice address
- 999 E Main St
Waupun, WI 53963-2210 - Phone
- (920) 324-4696
- NPI assigned
- Nov 16, 2011
- Last updated
- Nov 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | WI11142-040 | WI | Primary |
Addresses
Primary practice location
999 E Main St
Waupun, WI 53963-2210
Mailing address
717 Lincoln St
Ripon, WI 54971-1620
Phone (920) 748-6008
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 |
|---|---|---|---|
| WI11142-040 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1356628564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 LINCOLN ST",
"city": "RIPON",
"state": "WI",
"postal_code": "549711620",
"telephone_number": "920-748-6008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 E MAIN ST",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539632210",
"telephone_number": "920-324-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WSZALEK",
"first_name": "DALE",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "WI11142-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupun, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.