Active NPI
Sara Elizabeth Hensley, PHARMD.
- Pharmacist
- Mount Vernon, IL
National Provider Identifier
1477835114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.292798
- Practice address
- 3001 Broadway St
Mount Vernon, IL 62864-2361 - Phone
- (618) 242-1442
- Fax
- (618) 242-1293
- NPI assigned
- Sep 19, 2011
- Last updated
- Jul 12, 2021
- 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 | 051.292798 | IL | Primary |
Addresses
Primary practice location
3001 Broadway St
Mount Vernon, IL 62864-2361
Mailing address
5291 Cross Road
Salem, IL 62881
Phone (618) 292-9639
Other names 1
- Dr. Sara Elizabeth Koebele
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 |
|---|---|---|---|
| 051.292798 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1477835114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5291 CROSS ROAD",
"city": "SALEM",
"state": "IL",
"postal_code": "62881",
"telephone_number": "618-292-9639",
"fax_number": "618-242-1293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 BROADWAY ST",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642361",
"telephone_number": "618-242-1442",
"fax_number": "618-242-1293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENSLEY",
"first_name": "SARA",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHARMD.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-19",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.292798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "KOEBELE",
"middle_name": "ELIZABETH",
"prefix": "DR.",
"credential": "PHARM D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Vernon, IL
- Heartland Occupational Medicine Physicians of Illinois S C (UltiMed Plus)
- Heartland Radiology Associates LTD
- Heartland Women's Healthcare, LTD (Heartland Women's Healthcare)
- Morgan Lynn Virginia Henry
- Elizabeth A Hensley, M.S., L.C.P.C.
- Heritage Woods of Mt. Vernon, LLC
- Christopher Michael Herman, RPH
- Sierra S Hiestand
- Highland Park CVS, L.L.C. (CVS Pharmacy 6370)
- Hill-Rom Company, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.