Individual provider Active NPI

Vicki K Fong, RPH

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1679858104
Registry record updated Oct 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.036154 Issued in IL
Practice address
316 W Cermak Rd
Chicago, IL 60616-1916
Phone
(312) 791-0392
Fax
(312) 791-0461
NPI assigned
Oct 16, 2011
Last updated
Oct 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.036154 IL Primary

Addresses

Primary practice location

316 W Cermak Rd
Chicago, IL 60616-1916

Mailing address

228 W Alexander St
Chicago, IL 60616-1910
Phone (312) 842-1680

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

LicenseStateTypeSpecialty
051.036154ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318723200000",
    "number": "1679858104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W ALEXANDER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161910",
            "telephone_number": "312-842-1680",
            "fax_number": "312-842-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161916",
            "telephone_number": "312-791-0392",
            "fax_number": "312-791-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "VICKI",
        "middle_name": "K",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-16",
        "last_updated": "2011-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.036154",
            "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 Oct 16, 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.

Verify at the official NPI Registry.