Individual provider Active NPI

Dale Airola, RPH

  • Pharmacist
  • Lockport, IL
National Provider Identifier
1508312166
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051029129 Issued in IL
Practice address
17033 Burton Ave
Lockport, IL 60441-4607
Phone
(708) 285-3253
NPI assigned
Sep 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051029129 IL Primary

Addresses

Primary practice location

17033 Burton Ave
Lockport, IL 60441-4607

Mailing address

17033 Burton Ave
Lockport, IL 60441-4607
Phone (708) 285-3253

Other identifiers 1

IdentifierTypeStateIssuer
051029129OtherILSTATE LICENCE NUMBER

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
051029129ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1508312166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17033 BURTON AVE",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604414607",
            "telephone_number": "708-285-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17033 BURTON AVE",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604414607",
            "telephone_number": "708-285-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIROLA",
        "first_name": "DALE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051029129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "051029129",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.