Peter Drew Clarke II, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051301972 Issued in IL

Practice address

1201 E State St
Rockford, IL 61104-2212

Phone

(815) 962-2812

NPI assigned

Sep 24, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1609483601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042212",
            "telephone_number": "815-962-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042212",
            "telephone_number": "815-962-2812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3135 Maryland Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611085917",
            "country_code": "US",
            "telephone_number": "779-774-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "PETER",
        "middle_name": "DREW",
        "name_suffix": "II",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051301972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "str.6002@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "1201 E State St",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611042212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jean K Clark, LCPC
• Jendaya M Clark
• Kyle R Clark, PA-C
• Mitchell Clark
• Kelsey Marie Clarke
• Jeremy Clausen, ATC, CSCS
• Clayton & Clayton Counseling, PLLC
• Matthew C. Clayton, MSW, LSW
• Jordan Cleary, APRN
• Michelle Lee Cleveland, NP

• Pharmacist in Rockford, IL
• Providers in Rockford, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.