Krystian J Wojdyla, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.303877 Issued in IL

Practice address

300 E Walnut St
Watseka, IL 60970-1359

Phone

(815) 432-4172

NPI assigned

May 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highland Park CVS, L.L.C.

  • Pharmacy
  • Watseka, IL
  • NPI 1003919770
  NPD (past)

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1700452091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14930 W WHITNEY ST",
            "city": "MANHATTAN",
            "state": "IL",
            "postal_code": "604425047",
            "telephone_number": "773-669-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E WALNUT ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701359",
            "telephone_number": "815-432-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJDYLA",
        "first_name": "KRYSTIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.303877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Weidenbenner, LCPC
• Cristiane White, MHS CCC-SLP
• Ryan Charles Scott Whitesell, RN-FNP
• Ashlan Wicks
• Sarah Willis, MA
• Jordan Rae Yeoman, PHARMD
• Marcy E Zumwalt, N.P.
• Philip Frank Zumwalt, M.D.

• Pharmacist in Watseka, IL
• Providers in Watseka, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.