Individual provider Active NPI

Minette Lingan Punsalan

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1649921032
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051297082 Issued in IL
Practice address
10900 S Doty Ave
Chicago, IL 60628-3804
Phone
(773) 344-9061
NPI assigned
Jan 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051297082 IL Primary

Addresses

Primary practice location

10900 S Doty Ave
Chicago, IL 60628-3804

Mailing address

1145 N Leavitt St
Chicago, IL 60622-3505
Phone (847) 571-1067

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
051297082ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1649921032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 N LEAVITT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223505",
            "telephone_number": "847-571-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 S DOTY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283804",
            "telephone_number": "773-344-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNSALAN",
        "first_name": "MINETTE",
        "middle_name": "LINGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051297082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.