Individual provider Active NPI

Desiree Sacinski

  • Pharmacist
  • Palos Heights, IL
National Provider Identifier
1427333269
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051286211 Issued in IL
Practice address
12659 S Ridgeland Ave
Walgreens #9347
Palos Heights, IL 60463-1871
Phone
(708) 385-0218
Fax
(708) 385-1045
NPI assigned
Oct 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051286211 IL Primary

Addresses

Primary practice location

12659 S Ridgeland Ave
Walgreens #9347
Palos Heights, IL 60463-1871

Mailing address

12659 S Ridgeland Ave
Walgreens #9347
Palos Heights, IL 60463-1871

Other identifiers 1

IdentifierTypeStateIssuer
051286211OtherILLICENSE

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

LicenseStateTypeSpecialty
051286211ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1427333269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12659 S RIDGELAND AVE",
            "address_2": "WALGREENS #9347",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12659 S RIDGELAND AVE",
            "address_2": "WALGREENS #9347",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631871",
            "telephone_number": "708-385-0218",
            "fax_number": "708-385-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACINSKI",
        "first_name": "DESIREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "051286211",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

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

Verify at the official NPI Registry.