Michael Haare
Individual provider Active NPI Pharmacist · Monmouth, IL
NPI 1508477159 · NPPES record last updated Aug 16, 2020
Key facts
- NPI
- 1508477159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051302062 (IL)
- Practice address
- 600 N Main St
Monmouth, IL 61462-1267 - Phone
- (309) 734-6644
- Fax
- (309) 734-6663
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051302062 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051302062 | IL | Yes |
Addresses
Primary practice location
600 N Main St
Monmouth, IL 61462-1267
Mailing address
600 N Main St
Monmouth, IL 61462-1267
Phone (309) 734-6644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051302062 | Other | IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSINAL REGULATION |
Other providers in Monmouth, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.