Active NPI
Edward A Wolgemuth, RPH
- Pharmacist
- Oak Lawn, IL
National Provider Identifier
1720273501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 9424 S Pulaski Rd
Oak Lawn, IL 60453-1935 - Phone
- (708) 857-8274
- Fax
- (708) 857-8128
- NPI assigned
- Sep 13, 2007
- Sex
- Male
- 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 | IL | Primary |
Addresses
Primary practice location
9424 S Pulaski Rd
Oak Lawn, IL 60453-1935
Mailing address
9424 S Pulaski Rd
Oak Lawn, IL 60453-1935
Phone (708) 857-8274
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 |
|---|---|---|---|
| 051.032886 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores LLC | Past | Accepting new patients | |
| American Drug Stores LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Diamond, IL
- NPI 1013786706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1720273501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9424 S PULASKI RD",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604531935",
"telephone_number": "708-857-8274",
"fax_number": "708-857-8128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9424 S PULASKI RD",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604531935",
"telephone_number": "708-857-8274",
"fax_number": "708-857-8128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLGEMUTH",
"first_name": "EDWARD",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-13",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.