Active NPI
Kaitlin Juricek, PHARMD
- Pharmacist
- New Lenox, IL
National Provider Identifier
1407459514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051300602
- Practice address
- 1900 Silver Cross Blvd
New Lenox, IL 60451-9509 - Phone
- (815) 300-1100
- NPI assigned
- Nov 19, 2020
- Last updated
- Apr 30, 2024
- 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 | 051300602 | IL | Primary |
Addresses
Primary practice location
1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Mailing address
1849 Grandview Dr
New Lenox, IL 60451-2228
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 |
|---|---|---|---|
| 051300602 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Park CVS LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1407459514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1849 GRANDVIEW DR",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604512228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 SILVER CROSS BLVD",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604519509",
"telephone_number": "815-300-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURICEK",
"first_name": "KAITLIN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051300602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lenox, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.