Active NPI
Mary Southard, RPH
- Pharmacist
- Northbrook, IL
National Provider Identifier
1417318072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051035853
- Practice address
- 2775 Sanders Rd
Northbrook, IL 60062-6110 - Phone
- (847) 402-9400
- NPI assigned
- Mar 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 051035853 | IL | Primary |
Addresses
Primary practice location
2775 Sanders Rd
Northbrook, IL 60062-6110
Mailing address
1006 Linden Ave
Wilmette, IL 60091-2734
Phone (612) 345-0263
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051035853 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457568000000",
"number": "1417318072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 LINDEN AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600912734",
"telephone_number": "612-345-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2775 SANDERS RD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600626110",
"telephone_number": "847-402-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHARD",
"first_name": "MARY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-10",
"last_updated": "2016-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051035853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.