Active NPI
Jacquelyn Serena Versis, PHARMD
- Pharmacist
- Plainfield, IL
National Provider Identifier
1801166244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.297375
- Practice address
- 4822 Caton Farm Rd
Plainfield, IL 60586-8262 - Phone
- (815) 439-5882
- NPI assigned
- Jan 3, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS48047 | FL | |
| Pharmacist | 183500000X | 051.297375 | IL | Primary |
Addresses
Primary practice location
4822 Caton Farm Rd
Plainfield, IL 60586-8262
Mailing address
4822 Caton Farm Rd
Plainfield, IL 60586-8262
Phone (815) 439-5882
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS48047 | FL | MD | Pharmacist |
| 051.297375 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1801166244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4822 CATON FARM RD",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605868262",
"telephone_number": "815-439-5882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4822 CATON FARM RD",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605868262",
"telephone_number": "815-439-5882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERSIS",
"first_name": "JACQUELYN",
"middle_name": "SERENA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-03",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS48047",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.297375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.