Active NPI
Amy Beth Elliott, RPH
- Pharmacist
- Dekalb, IL
National Provider Identifier
1457636227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051041053
- Practice address
- 100 West Lincoln Hwy
Dekalb, IL 60115 - Phone
- (815) 756-1815
- Fax
- (815) 748-5527
- NPI assigned
- Oct 12, 2011
- Last updated
- Oct 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 | 051041053 | IL | Primary |
Addresses
Primary practice location
100 West Lincoln Hwy
Dekalb, IL 60115
Mailing address
672 Fox Hollow
Dekalb, IL 60115
Phone (815) 756-4654
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 |
|---|---|---|---|
| 051041053 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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": "1457636227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "672 FOX HOLLOW",
"city": "DEKALB",
"state": "IL",
"postal_code": "60115",
"telephone_number": "815-756-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WEST LINCOLN HWY",
"city": "DEKALB",
"state": "IL",
"postal_code": "60115",
"telephone_number": "815-756-1815",
"fax_number": "815-748-5527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "AMY",
"middle_name": "BETH",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-12",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051041053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, 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.