Active NPI
Jade Denae Huizenga, PHARMD, B.S., B.A.
- Pharmacist
- Oak Lawn, IL
National Provider Identifier
1801181839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.291765
- Practice address
- 4120 W 95TH St
Target-2087
Oak Lawn, IL 60453-2675 - Phone
- (708) 741-4070
- Fax
- (708) 741-4069
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.291765 | IL | Primary |
Addresses
Primary practice location
4120 W 95TH St
Target-2087
Oak Lawn, IL 60453-2675
Mailing address
4120 W 95TH St
Target-2087
Oak Lawn, IL 60453-2675
Phone (708) 741-4070
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
- Bachelor of Arts, Bachelor of Science, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.291765 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308268800000",
"number": "1801181839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4120 W 95TH ST",
"address_2": "TARGET-2087",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532675",
"telephone_number": "708-741-4070",
"fax_number": "708-741-4069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 W 95TH ST",
"address_2": "TARGET-2087",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532675",
"telephone_number": "708-741-4070",
"fax_number": "708-741-4069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUIZENGA",
"first_name": "JADE",
"middle_name": "DENAE",
"credential": "PHARMD, B.S., B.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2011-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.291765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.