Active NPI
Stephanie Ward Gordon, PHARM.D., M.S.
- Pharmacist
- Spring Grove, IL
National Provider Identifier
1366564288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.293731
- Practice address
- 7880 Winn Rd
Spring Grove, IL 60081-9687 - Phone
- (815) 675-2408
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.293731 | IL | Primary |
| Pharmacist | 183500000X | PS41327 | FL | |
| Pharmacist | 183500000X | RPH023915 | GA |
Addresses
Primary practice location
7880 Winn Rd
Spring Grove, IL 60081-9687
Mailing address
7880 Winn Rd
Spring Grove, IL 60081-9687
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
- Master of Science, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS41327 | FL | MD | Pharmacist |
| RPH023915 | GA | MD | Pharmacist |
| 051.293731 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1366564288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7880 WINN RD",
"city": "SPRING GROVE",
"state": "IL",
"postal_code": "600819687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7880 WINN RD",
"city": "SPRING GROVE",
"state": "IL",
"postal_code": "600819687",
"telephone_number": "815-675-2408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "STEPHANIE",
"middle_name": "WARD",
"name_prefix": "Dr.",
"credential": "PHARM.D., M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.293731",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS41327",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023915",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.