Individual provider Active NPI

Nancy Jo Wilsak, RPH

  • Pharmacist
  • Hines, IL
National Provider Identifier
1457439259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Practice address
1St Ave-1 BLK N of Cermak Rd
BLDG 37 Room139
Hines, IL 60141
Phone
(707) 896-7869
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Primary

Addresses

Primary practice location

1St Ave-1 BLK N of Cermak Rd
BLDG 37 Room139
Hines, IL 60141

Mailing address

6734 Blackburn PL
Downers Grove, IL 60516-3643
Phone (630) 515-0673

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

LicenseStateTypeSpecialty
051.034501ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457439259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6734 BLACKBURN PL",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163643",
            "telephone_number": "630-515-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1ST AVE-1 BLK N OF CERMAK RD",
            "address_2": "BLDG 37 ROOM139",
            "city": "HINES",
            "state": "IL",
            "postal_code": "60141",
            "telephone_number": "707-896-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSAK",
        "first_name": "NANCY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.