Individual provider Active NPI

Jerry Szczybura, PHARMD

  • Pharmacist
  • Wheaton, IL
National Provider Identifier
1780985671
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-286379 Issued in IL
Practice address
91 Danada SQ E
Wheaton, IL 60189-8484
Phone
(630) 260-9944
Fax
(630) 510-7123
NPI assigned
Nov 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-286379 IL Primary

Addresses

Primary practice location

91 Danada SQ E
Wheaton, IL 60189-8484

Mailing address

91 Danada SQ E
Wheaton, IL 60189-8484
Phone (630) 260-9944

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
051-286379ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1780985671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 DANADA SQ E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898484",
            "telephone_number": "630-260-9944",
            "fax_number": "630-510-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 DANADA SQ E",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601898484",
            "telephone_number": "630-260-9944",
            "fax_number": "630-510-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZCZYBURA",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-286379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.