Active NPI
Jacqueline Nissen, PHARMD
- Pharmacist
- Wheaton, IL
National Provider Identifier
1912501032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051301692
- Practice address
- 601 S County Farm Rd
Wheaton, IL 60187-4529 - Phone
- (630) 510-1685
- NPI assigned
- Nov 30, 2020
- Last updated
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 051301692 | IL | Primary |
Addresses
Primary practice location
601 S County Farm Rd
Wheaton, IL 60187-4529
Mailing address
601 S County Farm Rd
Wheaton, IL 60187-4529
Phone (630) 510-1685
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051301692 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1912501032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 S COUNTY FARM RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601874529",
"telephone_number": "630-510-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S COUNTY FARM RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601874529",
"telephone_number": "630-510-1685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISSEN",
"first_name": "JACQUELINE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051301692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
- My Phuong Luu Nguyen, PHARM.D.
- Nicholas & Noble Psychological Associates
- Andrew Nichols C Nichols, MSW, LCSW
- John M. Nihill, DDS
- Patricia Nihill, D.M.D., M.S.
- Margaret Noble
- Katherine Noll, PH.D.
- Christopher Nonnie, L.P.C. , C.A.D.C.
- Northeast Family Services of Illinois, Inc.
- Northern Illinois Foot & Ankle Specialists, LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.