Michael Andes, PHARM.D – Pharmacist in Effingham, IL

Key facts

NPI: 1780193425
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 051291942 (IL)
Practice address: 805 W Fayette Ave
Effingham, IL 62401-2415
Phone: (217) 342-9393
NPI assigned: Sep 26, 2017
Sex: Male
Sole proprietor: No

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.

G M Andes LTD Community/Retail Pharmacy · Effingham, IL · NPI 1740230481

NPD
G M Andes LTD Long Term Care Pharmacy · Effingham, IL · NPI 1932609278

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
051291942	IL	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
G M Andes LTD		Current	Accepting new patients
G M Andes LTD		Current	Accepting new patients

Locations

805 W Fayette Ave
Effingham, IL 62401
Phone (217) 342-9393

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	051291942	IL	Yes

Addresses

Primary practice location

805 W Fayette Ave
Effingham, IL 62401-2415

Mailing address

805 W Fayette Ave
Effingham, IL 62401-2415
Phone (217) 342-9393

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 12, 2020.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1780193425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W FAYETTE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012415",
            "telephone_number": "217-342-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W FAYETTE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012415",
            "telephone_number": "217-342-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDES",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051291942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

All providers in Effingham, IL · Pharmacist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.