Mary Beth Robertson, PHARM D
Individual provider Active NPI Pharmacist · Joliet, IL
NPI 1376866475 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1376866475
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051291755 (IL)
- Practice address
- 358 E Cass St
Joliet, IL 60432-2835 - Phone
- (815) 727-0033
- Fax
- (815) 727-5398
- NPI assigned
- Mar 4, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051291755 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051291755 | IL | Yes |
Addresses
Primary practice location
358 E Cass St
Joliet, IL 60432-2835
Mailing address
358 E. Cass St
Joliet, IL 60432
Phone (815) 727-0033
Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.