Jami Michelle Park
Individual provider Active NPI Pharmacist · Rushville, IL
NPI 1902180482 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1902180482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051-040991 (IL)
- Practice address
- 124 N Congress St
Rushville, IL 62681-1486 - Phone
- (217) 322-3333
- Fax
- (217) 322-6229
- NPI assigned
- Oct 3, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 051-040991 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moreland and Devitt, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-040991 | IL | Yes |
Addresses
Primary practice location
124 N Congress St
Rushville, IL 62681-1486
Mailing address
124 N Congress St
Rushville, IL 62681-1486
Phone (217) 322-3333
Other providers in Rushville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. 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.