Active NPI
Dick J Derks, PHARMD
- Pharmacist
- River Forest, IL
National Provider Identifier
1366723868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051289507
- Practice address
- 7251 Lake St
River Forest, IL 60305-2238 - Phone
- (708) 366-9960
- Fax
- (708) 366-1585
- NPI assigned
- Aug 29, 2011
- Last updated
- Aug 29, 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 | 051289507 | IL | Primary |
Addresses
Primary practice location
7251 Lake St
River Forest, IL 60305-2238
Mailing address
1020 S Wabash Ave
Unit 4C
Chicago, IL 60605-2256
Phone (708) 870-3674
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051289507 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314576000000",
"number": "1366723868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 S WABASH AVE",
"address_2": "UNIT 4C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052256",
"telephone_number": "708-870-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7251 LAKE ST",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603052238",
"telephone_number": "708-366-9960",
"fax_number": "708-366-1585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERKS",
"first_name": "DICK",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-29",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051289507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Forest, IL
- Kevin P. Cullinane, M.D.
- Karen Vanslyck Darley, DDS
- Lynda Kerstin De la Cotera, M.A.M.S.
- Amy Allyssa Deegan, LCSW
- Beatrice Defranco, LMT
- Dhanalakshmi P Ganesan MD, SC (Grand Medical Center)
- Dhanalakshmi P. Ganesan M.D.S.C
- Dhanalakshmi P. Ganesan MD SC (Grand-Dupage Clinic)
- Rutheva Dizon-Moore, MD
- Dominican University Wellness Center (Wellness Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.