Individual provider Active NPI

Terrence J Eckstein, RPH

  • Pharmacist
  • Montgomery, IL
National Provider Identifier
1487935326
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-036250 Issued in IL
Practice address
1212 Ogden Ave
Montgomery, IL 60538-5400
Phone
(630) 820-4098
Fax
(630) 820-5393
NPI assigned
Sep 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 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 051-036250 IL Primary

Addresses

Primary practice location

1212 Ogden Ave
Montgomery, IL 60538-5400

Mailing address

1212 Ogden Ave
Montgomery, IL 60538-5400
Phone (630) 820-4098

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

LicenseStateTypeSpecialty
051-036250ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1487935326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 OGDEN AVE",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605385400",
            "telephone_number": "630-820-4098",
            "fax_number": "630-820-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 OGDEN AVE",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605385400",
            "telephone_number": "630-820-4098",
            "fax_number": "630-820-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKSTEIN",
        "first_name": "TERRENCE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-036250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.