Active NPI
Donald Andrade
- Pharmacist
- Galesburg, IL
National Provider Identifier
1609230978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-039135
- Practice address
- 1150 W Carl Sandburg Dr
Galesburg, IL 61401-1387 - Phone
- (309) 344-3088
- Fax
- (309) 344-3154
- NPI assigned
- Apr 12, 2016
- Sex
- Male
- 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 | 051-039135 | IL | Primary |
Addresses
Primary practice location
1150 W Carl Sandburg Dr
Galesburg, IL 61401-1387
Mailing address
1150 W Carl Sandburg Dr
Galesburg, IL 61401-1387
Phone (309) 344-3088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801827969 | Other | IL | NPI |
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 |
|---|---|---|---|
| 051-039135 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1609230978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 W CARL SANDBURG DR",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614011387",
"telephone_number": "309-344-3088",
"fax_number": "309-344-3154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 W CARL SANDBURG DR",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614011387",
"telephone_number": "309-344-3088",
"fax_number": "309-344-3154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRADE",
"first_name": "DONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-12",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-039135",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1801827969",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Galesburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.