Robert Mark Antonacci, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

051033253 Issued in IL

Practice address

1919 W Pioneer Pkwy
Peoria, IL 61615-1825

Phone

(309) 692-0045

Fax

(309) 692-2869

NPI assigned

Jul 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1821616459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W PIONEER PKWY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151825",
            "telephone_number": "309-692-0045",
            "fax_number": "309-692-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W PIONEER PKWY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151825",
            "telephone_number": "309-692-0045",
            "fax_number": "309-692-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONACCI",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051033253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.06604@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "Pharmacy Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1919 W Pioneer Pkwy",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616151825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vasantha L. Anne, M.D.
• Eugene Narkotey Annor, MD
• Daniel Ansbro, MD
• Kristin T Ansteatt, APRN, FNP-BC
• Antonacci Inc
• Reuben Antony, MD
• Apichart L Radee MD SC
• Apostolic Christian Home
• Kimberly Jo Applen, COTA/L
• Charles Aprahamian, MD

• Pharmacist in Peoria, IL
• Providers in Peoria, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.