Jerry Vance Hildebrandt, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

Practice address

401 N Wall St
Kankakee, IL 60901-2934

Phone

(815) 935-4356

Fax

(815) 935-4358

NPI assigned

Mar 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760511075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 DOLLY DR",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609501611",
            "telephone_number": "815-468-6330",
            "fax_number": "815-468-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012934",
            "telephone_number": "815-935-4356",
            "fax_number": "815-935-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "JERRY",
        "middle_name": "VANCE",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "09190",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Henderson
• Amy Hertz, R.D., L.D.N.
• Richard D Hess, D.D.S.
• Highland Park CVS LLC (CVS Pharmacy #02663)
• Allison Marie Hildebrand, PTA
• India Katrice Hill
• Joshua Robert Hines, D.C.
• Hippocrates Medical Clinic
• Kendreea Marie Hodges, CNP
• Fatima Hooda, DO

• Pharmacist in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.