Individual provider Active NPI

Daniel Bruce Henley, PHARMD

  • Pharmacist
  • Naperville, IL
National Provider Identifier
1457620130
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051286824 Issued in IL
Practice address
4295 Gardenview Dr
Apt 111
Naperville, IL 60564-1624
Phone
(618) 364-6747
NPI assigned
Dec 23, 2011
Last updated
Dec 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 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 051286824 IL Primary

Addresses

Primary practice location

4295 Gardenview Dr
Apt 111
Naperville, IL 60564-1624

Mailing address

4295 Gardenview Dr
Apt 111
Naperville, IL 60564-1624
Phone (618) 364-6747

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051286824ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1457620130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4295 GARDENVIEW DR",
            "address_2": "APT 111",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605641624",
            "telephone_number": "618-364-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 GARDENVIEW DR",
            "address_2": "APT 111",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605641624",
            "telephone_number": "618-364-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "DANIEL",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.