Active NPI
Jennifer Colletta, PHARM D
- Pharmacist
- Elgin, IL
National Provider Identifier
1386925816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051292565
- Practice address
- 1700 Larkin Ave
Elgin, IL 60123-5947 - Phone
- (847) 695-1158
- NPI assigned
- Aug 29, 2011
- Sex
- Female
- 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 | 051292565 | IL | Primary |
Addresses
Primary practice location
1700 Larkin Ave
Elgin, IL 60123-5947
Mailing address
1700 Larkin Ave
Elgin, IL 60123-5947
Phone (847) 695-1158
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 |
|---|---|---|---|
| 051292565 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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.
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": "1386925816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 LARKIN AVE",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235947",
"telephone_number": "847-695-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 LARKIN AVE",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235947",
"telephone_number": "847-695-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLETTA",
"first_name": "JENNIFER",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-29",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051292565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elgin, IL
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.