Active NPI
Danielle Kanallakan
- Pharmacist
- Jerseyville, IL
National Provider Identifier
1568746857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-286207
- Practice address
- 705 S State St
Jerseyville, IL 62052-2340 - Phone
- (618) 498-4989
- NPI assigned
- Oct 5, 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 | 051-286207 | IL | Primary |
Addresses
Primary practice location
705 S State St
Jerseyville, IL 62052-2340
Mailing address
802 West Carpenter
Jerseyville, IL 62052
Phone (618) 639-8188
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 |
|---|---|---|---|
| 051-286207 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1568746857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 WEST CARPENTER",
"city": "JERSEYVILLE",
"state": "IL",
"postal_code": "62052",
"telephone_number": "618-639-8188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S STATE ST",
"city": "JERSEYVILLE",
"state": "IL",
"postal_code": "620522340",
"telephone_number": "618-498-4989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANALLAKAN",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-05",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-286207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jerseyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.