Individual provider Active NPI

Heather Boslem

  • Pharmacy Technician
  • Machesney Park, IL
National Provider Identifier
1922498484
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
049172268 Issued in IL
Practice address
1016 Emerald LN
Machesney Park, IL 61115-2130
Phone
(815) 289-8435
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 049172268 IL Primary

Addresses

Primary practice location

1016 Emerald LN
Machesney Park, IL 61115-2130

Mailing address

9833 N Alpine Rd
Machesney Park, IL 61115-1681

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

State licenses

LicenseStateTypeSpecialty
049172268ILMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1922498484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9833 N ALPINE RD",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611151681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 EMERALD LN",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611152130",
            "telephone_number": "815-289-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEM",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IL",
            "license": "049172268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Machesney Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.