Courtni Marie Eldridge, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

049.272946 Issued in IL

Practice address

5000 S 5TH Ave BLDG 37
Hines, IL 60141-3030

Phone

(708) 786-7821

NPI assigned

Jan 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hines VA Cmop

  • Department of Veterans Affairs (VA) Pharmacy
  • Hines, IL
  • NPI 1700834116
  NPD (past)

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1922696533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S LEAVITT ST APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123116",
            "telephone_number": "815-618-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE BLDG 37",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-786-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "COURTNI",
        "middle_name": "MARIE",
        "credential": "CPHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "060776961",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "IL",
            "license": "049.272946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Alan Edwards, MA, CVRT
• Jamesetta Edwards, BFA
• Melissa Edwards, PHARM.D
• Michael McDonald Egan, CNP
• David Bernard Eilers, M.D.
• Margaret Elgersma
• Ileana Antonia Elicier, PT
• Paul B Ellin, P.T.
• Emily Ellsworth, PHARMD
• Jasmine Emmanuel, NURSE PRACTITIONER

• Pharmacy Technician in Hines, IL
• Providers in Hines, IL by specialty
• Pharmacy Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.