Individual provider Active NPI

Rose-Vicky Rosete Gerasmo, RPH

  • Pharmacist
  • Hines, IL
National Provider Identifier
1740451905
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
Practice address
GL-Cmop Roosevelt Rd, 5TH Ave
BDLG. 37 NW
Hines, IL 60141-5221
Phone
(708) 786-7820
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IL Primary

Addresses

Primary practice location

GL-Cmop Roosevelt Rd, 5TH Ave
BDLG. 37 NW
Hines, IL 60141-5221

Mailing address

34715 N Holman Ave
Ingleside, IL 60041-9573
Phone (847) 740-5813

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
051292251ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1740451905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34715 N HOLMAN AVE",
            "city": "INGLESIDE",
            "state": "IL",
            "postal_code": "600419573",
            "telephone_number": "847-740-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GL-CMOP ROOSEVELT RD, 5TH AVE",
            "address_2": "BDLG. 37 NW",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601415221",
            "telephone_number": "708-786-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERASMO",
        "first_name": "ROSE-VICKY",
        "middle_name": "ROSETE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.