Active NPI
Jean Anciaux
- Pharmacist
- Moline, IL
National Provider Identifier
1619009297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 2014 1St Street a
Moline, IL 61265-7728 - Phone
- (309) 797-9286
- Fax
- (309) 797-0199
- NPI assigned
- Mar 10, 2007
- Last updated
- Jul 25, 2007
- 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 | IL | Primary |
Addresses
Primary practice location
2014 1St Street a
Moline, IL 61265-7728
Mailing address
4722 Torrey Pines CT
Davenport, IA 52807-3301
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 |
|---|---|---|---|
| 051034819 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1619009297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4722 TORREY PINES CT",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528073301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2014 1ST STREET A",
"city": "MOLINE",
"state": "IL",
"postal_code": "612657728",
"telephone_number": "309-797-9286",
"fax_number": "309-797-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCIAUX",
"first_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-10",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
- American Current Care of Illinois PC (Concentra Immediate Care)
- American Current Care of Illinois PC (Concentra Immediate Care)
- American Drug Stores LLC (Osco Drug #0122)
- American Prosthetics & Orthotics, Inc. (Hanger Clinic III)
- Amicare Pharmacy, Inc (Hart Medical Supply)
- Cynthia L Anderson-Dobroski
- Maria Anderson-Dooley, D.C.
- Brian D Anderson, DO
- Elizabeth Anderson, MA
- Jane Anderson, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.