Active NPI
Christine Lynn Petrick
- Pharmacy Technician
- Tinley Park, IL
National Provider Identifier
1760072250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 049272348
- Practice address
- 16675 Oak Park Ave
Tinley Park, IL 60477-1754 - Phone
- (708) 429-0880
- NPI assigned
- Jan 19, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 049272348 | IL | Primary |
Addresses
Primary practice location
16675 Oak Park Ave
Tinley Park, IL 60477-1754
Mailing address
16675 Oak Park Ave
Tinley Park, IL 60477-1754
Phone (708) 429-0880
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
| License | State | Type | Specialty |
|---|---|---|---|
| 049272348 | IL | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1760072250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16675 OAK PARK AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771754",
"telephone_number": "708-429-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16675 OAK PARK AVE",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771754",
"telephone_number": "708-429-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRICK",
"first_name": "CHRISTINE",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IL",
"license": "049272348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.