Active NPI
Ethel Worthon
- Pharmacist
- Calumet City, IL
National Provider Identifier
1619251642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051041161
- Practice address
- 522 Torrence Ave
Calumet City, IL 60409-3216 - Phone
- (708) 868-5669
- NPI assigned
- Oct 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 051041161 | IL | Primary |
Addresses
Primary practice location
522 Torrence Ave
Calumet City, IL 60409-3216
Mailing address
3119 Holden Cir
Matteson, IL 60443-4430
Phone (708) 932-6560
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 |
|---|---|---|---|
| 051041161 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1619251642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3119 HOLDEN CIR",
"city": "MATTESON",
"state": "IL",
"postal_code": "604434430",
"telephone_number": "708-932-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 TORRENCE AVE",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604093216",
"telephone_number": "708-868-5669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTHON",
"first_name": "ETHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-10",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051041161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calumet City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.