Individual provider Active NPI

Derek Szeliga, PHARMD

  • Pharmacist
  • Homer Glen, IL
National Provider Identifier
1669893012
Registry record updated Jan 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.296785 Issued in IL
Practice address
13252 W Pin Oak CT
Homer Glen, IL 60491-8692
Phone
(815) 300-7082
NPI assigned
Jan 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.296785 IL Primary

Addresses

Primary practice location

13252 W Pin Oak CT
Homer Glen, IL 60491-8692

Mailing address

13252 W Pin Oak CT
Homer Glen, IL 60491-8692

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.296785ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1388534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388534400000",
    "number": "1669893012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13252 W PIN OAK CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13252 W PIN OAK CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918692",
            "telephone_number": "815-300-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZELIGA",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-01",
        "last_updated": "2014-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.296785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2014; 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.