Active NPI
Synthia Diane Lindbloom, RPH
- Pharmacist
- Matteson, IL
National Provider Identifier
1992091961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-034123
- Practice address
- 4647 Promenade Way
T-2263
Matteson, IL 60443-2981 - Phone
- (708) 898-5009
- Fax
- (708) 898-5019
- NPI assigned
- Jun 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 051-034123 | IL | Primary |
Addresses
Primary practice location
4647 Promenade Way
T-2263
Matteson, IL 60443-2981
Mailing address
4647 Promenade Way
T-2263
Matteson, IL 60443-2981
Phone (708) 898-5009
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-034123 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1992091961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4647 PROMENADE WAY",
"address_2": "T-2263",
"city": "MATTESON",
"state": "IL",
"postal_code": "604432981",
"telephone_number": "708-898-5009",
"fax_number": "708-898-5019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4647 PROMENADE WAY",
"address_2": "T-2263",
"city": "MATTESON",
"state": "IL",
"postal_code": "604432981",
"telephone_number": "708-898-5009",
"fax_number": "708-898-5019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDBLOOM",
"first_name": "SYNTHIA",
"middle_name": "DIANE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-034123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matteson, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.