Active NPI
Brian Headtke, PHARMD
- Pharmacist
- Naperville, IL
National Provider Identifier
1467577296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051289868
- Practice address
- 3116 State Route 59
Naperville, IL 60564-8109 - Phone
- (630) 922-1704
- Fax
- (630) 922-1707
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 051289868 | IL | Primary |
Addresses
Primary practice location
3116 State Route 59
Naperville, IL 60564-8109
Mailing address
23W280 Saint James CT
Glen Ellyn, IL 60137-6531
Phone (630) 730-7435
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051289868 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1467577296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23W280 SAINT JAMES CT",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601376531",
"telephone_number": "630-730-7435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3116 STATE ROUTE 59",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605648109",
"telephone_number": "630-922-1704",
"fax_number": "630-922-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEADTKE",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051289868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
- William 4 Hays
- Wendy Eileen Hayum-Gross, LCPC NCC
- Katelyn Marie Hazelett, NP
- HC Remotely, SC
- Emily Victoria Headley, PA-C
- Healing Grace Counseling Center
- Healing Grace Counseling, LTD.
- Healing Health Holiness: a Wholistic Approach to Physical Therapy LLC
- Healing Mind Counseling Services LLC
- Healing Partners Plus PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.