Active NPI
Anna Stephanie Kabakov, PHARMD, MBA, BCPS
- Pharmacotherapy Pharmacist
- Evanston, IL
National Provider Identifier
1952669293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 3130950
- Practice address
- 2650 Ridge Ave
Evanston, IL 60201-1718 - Phone
- (847) 570-2911
- NPI assigned
- Apr 24, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.295032 | IL | |
| Pharmacotherapy Pharmacist | 1835P1200X | 3130950 | IL | Primary |
Addresses
Primary practice location
2650 Ridge Ave
Evanston, IL 60201-1718
Mailing address
1503 Broadway CT
Wheeling, IL 60090-6931
Phone (847) 814-4853
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
- Master of Business Administration, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.295032 | IL | MD | Pharmacist |
| 3130950 | IL | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1952669293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1503 BROADWAY CT",
"city": "WHEELING",
"state": "IL",
"postal_code": "600906931",
"telephone_number": "847-814-4853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "847-570-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KABAKOV",
"first_name": "ANNA",
"middle_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PHARMD, MBA, BCPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-24",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.295032",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "IL",
"license": "3130950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.