Cody A Holler, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051303007 Issued in IL

Practice address

655 Main St NW
Bourbonnais, IL 60914-2303

Phone

(815) 929-0590

NPI assigned

Jun 4, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Drug Stores LLC

  • Community/Retail Pharmacy
  • Diamond, IL
  • NPI 1013786706
  NPD (past)
• American Drug Stores LLC

  dba Osco Drug #2488

  • Community/Retail Pharmacy
  • Bourbonnais, IL
  • NPI 1114973880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1396369302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9487 W GOLFVIEW DR",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237958",
            "telephone_number": "708-305-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MAIN ST NW",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142303",
            "telephone_number": "815-929-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "CODY",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26028639A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051303007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Hoang
• Erica C Hodges
• Hoffman Chiropractic Clinic PC
• Matthew Patrick Hoffman, DC
• Dustin Taylor Hogan
• Home Care Personal Services, Inc.
• Megan Hoskins, RBT-17-40711
• Hospice of Kankakee Valley Palliative Clinic
• Hospice of Kankakee Valley, Inc.
• Denise Marie Houser, M.A., L.C.P.C, N.C.C

• Pharmacist in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.