Tandrea N Allison, RPH
Individual provider Active NPI Pharmacist · Normal, IL
NPI 1699059782 · NPPES record last updated Oct 6, 2011
Key facts
- NPI
- 1699059782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051-287575 (IL)
- Practice address
- 505 W Raab Rd
Normal, IL 61761-1007 - Phone
- (309) 454-7347
- NPI assigned
- Oct 6, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-287575 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-287575 | IL | Yes |
Addresses
Primary practice location
505 W Raab Rd
Normal, IL 61761-1007
Mailing address
16059 Garnet LN
Bloomington, IL 61705-6454
Phone (309) 828-3485
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.