Individual provider Active NPI

Bill Jerrels

  • Pharmacist
  • Harrisburg, IL
National Provider Identifier
1649860875
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051034232 Issued in IL
Practice address
304 S Commercial St
Harrisburg, IL 62946-2108
Phone
(618) 252-5349
Fax
(618) 252-1395
NPI assigned
Jan 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051034232 IL Primary

Addresses

Primary practice location

304 S Commercial St
Harrisburg, IL 62946-2108

Mailing address

304 S Commercial St
Harrisburg, IL 62946-2108
Phone (618) 252-5349

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

LicenseStateTypeSpecialty
051034232ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1649860875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S COMMERCIAL ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462108",
            "telephone_number": "618-252-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S COMMERCIAL ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462108",
            "telephone_number": "618-252-5349",
            "fax_number": "618-252-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRELS",
        "first_name": "BILL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051034232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.