Individual provider Active NPI

John Kunstman, PHARMD

  • Pharmacist
  • Sycamore, IL
National Provider Identifier
1740940709
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051304364 Issued in IL
Practice address
1340 Dekalb Ave
Sycamore, IL 60178-2765
Phone
(815) 895-4609
NPI assigned
Dec 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051304364 IL Primary

Addresses

Primary practice location

1340 Dekalb Ave
Sycamore, IL 60178-2765

Mailing address

2516 Alpha CT E
Dekalb, IL 60115-5835
Phone (815) 517-7292

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051304364ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1740940709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 ALPHA CT E",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601155835",
            "telephone_number": "815-517-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 DEKALB AVE",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782765",
            "telephone_number": "815-895-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNSTMAN",
        "first_name": "JOHN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051304364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

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