Individual provider Active NPI

Gloria Bertram, PHARMD

  • Pharmacist
  • Downers Grove, IL
National Provider Identifier
1477830578
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-040835 Issued in IL
Practice address
530 40TH St
Downers Grove, IL 60515-2256
Phone
(630) 852-3639
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 051-040835 IL Primary

Addresses

Primary practice location

530 40TH St
Downers Grove, IL 60515-2256

Mailing address

7155 W Foster Place
Chicago, IL 60656
Phone (773) 631-3927

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
051-040835ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1477830578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7155 W FOSTER PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60656",
            "telephone_number": "773-631-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 40TH ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152256",
            "telephone_number": "630-852-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "GLORIA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-040835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.