John Cooper, B.S.PHARM
Individual provider Active NPI Pharmacist · Ottawa, IL
NPI 1851668099 · NPPES record last updated Nov 16, 2011
Key facts
- NPI
- 1851668099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.291504 (IL)
- Practice address
- 545 E Norris Dr
Walgreens Store # 3009
Ottawa, IL 61350-2316 - Phone
- (815) 433-0485
- Fax
- (815) 433-3843
- NPI assigned
- Nov 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.291504 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.291504 | IL | Yes |
Addresses
Primary practice location
545 E Norris Dr
Walgreens Store # 3009
Ottawa, IL 61350-2316
Mailing address
545 E Norris Dr
Walgreens Store # 3009
Ottawa, IL 61350-2316
Phone (815) 433-0485
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.