Joanna Kaczmarczyk

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.301144 Issued in IL

Practice address

5555 W 79TH St
Burbank, IL 60459-1301

Phone

(708) 499-3755

NPI assigned

Jun 29, 2017

Sex

Female

Sole proprietor

Yes

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

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 and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Burbank, IL
  • NPI 1417962663
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1417478488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591301",
            "telephone_number": "708-499-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMARCZYK",
        "first_name": "JOANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IL",
            "license": "049190847",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.301144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jawanda Jones, FNP - BC
• Lidija Jovanovic, PHARMD
• Melissa Juarez, PA-C
• Ahmad Eyad Judeh
• Pamela Jung
• Kenneth Y Wu
• Areeg Khraiwish
• Susie Kim, MD
• Mai Vo Kirwan
• Nahawand Hasan Kishta, APRN-FNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.