Active NPI
Jessica Lynn Butzen
- Pharmacist
- Huntley, IL
National Provider Identifier
1497038939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.293758
- Practice address
- 9550 Route 47
Huntley, IL 60142 - Phone
- (847) 669-7590
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 21, 2011
- Sex
- Female
- 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 | 051.293758 | IL | Primary |
Addresses
Primary practice location
9550 Route 47
Huntley, IL 60142
Mailing address
9550 Route 47
Huntley, IL 60142
Phone (847) 669-7590
Other names 1
- Jessica Lynn Podkowa
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.293758 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1497038939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9550 ROUTE 47",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "60142",
"telephone_number": "847-669-7590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9550 ROUTE 47",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "60142",
"telephone_number": "847-669-7590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTZEN",
"first_name": "JESSICA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.293758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "PODKOWA",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Huntley, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.