Active NPI
John A Rennau
- Pharmacist
- La Grange Highlands, IL
National Provider Identifier
1407132103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051032344
- Practice address
- 6600 Willow Springs Rd
La Grange Highlands, IL 60525-4593 - Phone
- (708) 588-1253
- Fax
- (708) 588-1309
- NPI assigned
- Oct 25, 2011
- Sex
- Male
- 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 | 051032344 | IL | Primary |
Addresses
Primary practice location
6600 Willow Springs Rd
La Grange Highlands, IL 60525-4593
Mailing address
6600 Willow Springs Rd
La Grange Highlands, IL 60525-4593
Phone (708) 588-1253
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 |
|---|---|---|---|
| 051032344 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1407132103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 WILLOW SPRINGS RD",
"city": "LA GRANGE HIGHLANDS",
"state": "IL",
"postal_code": "605254593",
"telephone_number": "708-588-1253",
"fax_number": "708-588-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 WILLOW SPRINGS RD",
"city": "LA GRANGE HIGHLANDS",
"state": "IL",
"postal_code": "605254593",
"telephone_number": "708-588-1253",
"fax_number": "708-588-1309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNAU",
"first_name": "JOHN",
"middle_name": "A",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-25",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051032344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Grange Highlands, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.