Active NPI
David G. Fuentes Jr., PHARMD
- Psychiatric Pharmacist
- Schaumburg, IL
National Provider Identifier
1558640656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 55520
- Practice address
- 1400 N Roosevelt Blvd
245
Schaumburg, IL 60173-4377 - Phone
- (847) 330-4540
- NPI assigned
- Aug 8, 2011
- 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 |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 55520 | CA | Primary |
Addresses
Primary practice location
1400 N Roosevelt Blvd
245
Schaumburg, IL 60173-4377
Mailing address
1400 N Roosevelt Blvd
245
Schaumburg, IL 60173-4377
Phone (847) 330-4540
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
- Doctor of Pharmacy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312761600000",
"number": "1558640656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N ROOSEVELT BLVD",
"address_2": "245",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734377",
"telephone_number": "847-330-4540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N ROOSEVELT BLVD",
"address_2": "245",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734377",
"telephone_number": "847-330-4540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "DAVID",
"middle_name": "G.",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-08",
"last_updated": "2011-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "CA",
"license": "55520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.