Active NPI
David D Wegman, RPH, MS, FASCP, CGP
- Geriatric Pharmacist
- Minonk, IL
National Provider Identifier
1487958914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 051.031837
- Practice address
- 568 N Chestnut St
Minonk, IL 61760-1271 - Phone
- (309) 432-3451
- Fax
- (309) 432-3625
- NPI assigned
- Dec 23, 2010
- Last updated
- Dec 23, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 051.031837 | IL | Primary |
Addresses
Primary practice location
568 N Chestnut St
Minonk, IL 61760-1271
Mailing address
568 N Chestnut St
Minonk, IL 61760-1271
Phone (309) 432-3451
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
- Master of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.031837 | IL | MD | Geriatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Tree Pharmacy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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": "1293062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293062400000",
"number": "1487958914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "568 N CHESTNUT ST",
"city": "MINONK",
"state": "IL",
"postal_code": "617601271",
"telephone_number": "309-432-3451",
"fax_number": "309-432-3625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "568 N CHESTNUT ST",
"city": "MINONK",
"state": "IL",
"postal_code": "617601271",
"telephone_number": "309-432-3451",
"fax_number": "309-432-3625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGMAN",
"first_name": "DAVID",
"middle_name": "D",
"credential": "RPH, MS, FASCP, CGP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-23",
"last_updated": "2010-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "IL",
"license": "051.031837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minonk, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.