Individual provider Active NPI

Deborah Marie Stukus

  • Pharmacist
  • Palos Park, IL
National Provider Identifier
1740561950
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-035118 Issued in IL
Practice address
13023 S la Grange Rd
Palos Park, IL 60464-1718
Phone
(708) 361-2291
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 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 051-035118 IL Primary

Addresses

Primary practice location

13023 S la Grange Rd
Palos Park, IL 60464-1718

Mailing address

15816 Jon Rd
Oak Forest, IL 60452-2766

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

State licenses

LicenseStateTypeSpecialty
051-035118ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1740561950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15816 JON RD",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13023 S LA GRANGE RD",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641718",
            "telephone_number": "708-361-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKUS",
        "first_name": "DEBORAH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-035118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.