Active NPI
Jennifer J Kaczmarski, RPH
- Pharmacist
- Plainfield, IL
National Provider Identifier
1447545017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-286352
- Practice address
- 12800 S State Route 59
T-1403
Plainfield, IL 60585-5415 - Phone
- (815) 577-5105
- Fax
- (815) 577-5105
- NPI assigned
- Jun 12, 2011
- 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 | 051-286352 | IL | Primary |
Addresses
Primary practice location
12800 S State Route 59
T-1403
Plainfield, IL 60585-5415
Mailing address
12800 S State Route 59
T-1403
Plainfield, IL 60585-5415
Phone (815) 577-5105
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 |
|---|---|---|---|
| 051-286352 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307836800000",
"number": "1447545017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12800 S STATE ROUTE 59",
"address_2": "T-1403",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605855415",
"telephone_number": "815-577-5105",
"fax_number": "815-577-5105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12800 S STATE ROUTE 59",
"address_2": "T-1403",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605855415",
"telephone_number": "815-577-5105",
"fax_number": "815-577-5105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACZMARSKI",
"first_name": "JENNIFER",
"middle_name": "J",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-12",
"last_updated": "2011-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-286352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.