Active NPI
Sabina Wytrwal
- Pharmacist
- South Holland, IL
National Provider Identifier
1598368573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.303610
- Practice address
- 763 E 162ND St
South Holland, IL 60473-2331 - Phone
- (773) 773-2668
- NPI assigned
- Nov 20, 2020
- 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 | 051.303610 | IL | Primary |
Addresses
Primary practice location
763 E 162ND St
South Holland, IL 60473-2331
Mailing address
6669 Pine Lake Dr
Tinley Park, IL 60477-4934
Phone (773) 266-8240
Other practice location 1
6669 Pine Lake Dr
Tinley Park, IL 60477-4934
Phone (773) 266-8240
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Swytr00@safeway.com | Other |
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 |
|---|---|---|---|
| 051.303610 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1598368573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6669 PINE LAKE DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604774934",
"telephone_number": "773-266-8240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "763 E 162ND ST",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604732331",
"telephone_number": "773-773-2668"
}
],
"practiceLocations": [
{
"address_1": "6669 Pine Lake Dr",
"address_purpose": "LOCATION",
"city": "Tinley Park",
"state": "IL",
"postal_code": "604774934",
"country_code": "US",
"telephone_number": "773-266-8240",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYTRWAL",
"first_name": "SABINA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-20",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.303610",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Swytr00@safeway.com",
"affiliation": "N",
"endpointDescription": "Work email",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Other",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "763 E 162nd St",
"city": "South Holland",
"state": "IL",
"country_code": "US",
"postal_code": "604732331",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.