Active NPI
Mary Pubentz, R.PH.
- Pharmacist
- Rolling Meadows, IL
National Provider Identifier
1669715967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-039039
- Practice address
- 1701 Golf Rd
Suite 2-1100
Rolling Meadows, IL 60008-4227 - Phone
- (847) 635-4412
- Fax
- (847) 635-5915
- NPI assigned
- Apr 4, 2013
- 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 | 051-039039 | IL | Primary |
Addresses
Primary practice location
1701 Golf Rd
Suite 2-1100
Rolling Meadows, IL 60008-4227
Mailing address
1701 Golf Rd
Suite 2-1100
Rolling Meadows, IL 60008-4227
Phone (847) 635-4412
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-039039 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1669715967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 GOLF RD",
"address_2": "SUITE 2-1100",
"city": "ROLLING MEADOWS",
"state": "IL",
"postal_code": "600084227",
"telephone_number": "847-635-4412",
"fax_number": "847-635-5915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 GOLF RD",
"address_2": "SUITE 2-1100",
"city": "ROLLING MEADOWS",
"state": "IL",
"postal_code": "600084227",
"telephone_number": "847-635-4412",
"fax_number": "847-635-5915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUBENTZ",
"first_name": "MARY",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-04",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-039039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolling Meadows, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.