Nicholas Creek
Individual provider Active NPI Pharmacist · Mapleton, IL
NPI 1528938024 · NPPES record last updated Nov 10, 2025
Key facts
- NPI
- 1528938024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051302182 (IL)
- Practice address
- 4511 S Tewkesbury CT
Mapleton, IL 61547-9559 - Phone
- (309) 308-0453
- NPI assigned
- Nov 10, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 051302182 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051302182 | IL | Yes |
Addresses
Primary practice location
4511 S Tewkesbury CT
Mapleton, IL 61547-9559
Mailing address
4511 S Tewkesbury CT
Mapleton, IL 61547-9559
Phone (309) 308-0453
Other providers in Mapleton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2025. 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.