Active NPI
Cheryl Smith
- Pharmacist
- Alsip, IL
National Provider Identifier
1396357489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.302793
- Practice address
- 12290 S Pulaski Rd
Alsip, IL 60803-1405 - Phone
- (708) 385-2006
- NPI assigned
- Aug 19, 2020
- 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 | 051.302793 | IL | Primary |
Addresses
Primary practice location
12290 S Pulaski Rd
Alsip, IL 60803-1405
Mailing address
9114 S King Dr
Chicago, IL 60619-7363
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Alsip |
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 |
|---|---|---|---|
| 051.302793 | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1396357489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9114 S KING DR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606197363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12290 S PULASKI RD",
"city": "ALSIP",
"state": "IL",
"postal_code": "608031405",
"telephone_number": "708-385-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CHERYL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.302793",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Alsip",
"affiliation": "N",
"endpointDescription": "Walgreens",
"address_1": "12290 S Pulaski Rd",
"city": "Alsip",
"state": "IL",
"country_code": "US",
"postal_code": "608031405",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.