Individual provider Active NPI

Rebecca Marie Lizcano, RPH

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1811272982
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.037084 Issued in IL
Practice address
11833 S Western Ave
Chicago, IL 60643-4733
Phone
(773) 233-2245
NPI assigned
Oct 20, 2011
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.037084 IL Primary
Pharmacist 183500000X RPH 43041 CA

Addresses

Primary practice location

11833 S Western Ave
Chicago, IL 60643-4733

Mailing address

2121 W 100TH St
Chicago, IL 60643-2073

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH 43041CAMDPharmacist
051.037084ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1811272982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W 100TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11833 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434733",
            "telephone_number": "773-233-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZCANO",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.037084",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 43041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.