MS. ROBERTA ELISE MARRIOTT (NPI# 1104960046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104960046 |
| Entity Type | Individual |
| Full Name | MS. ROBERTA ELISE MARRIOTT |
| Practice Address |
1325 W 9th St Mount Carmel IL 62863-2906 |
| Mailing Address |
Po Box 416 Mount Carmel IL 62863-0416 |
| Practice Telephone | 6182634543 |
| Practice Fax Number | 6182625294 |
| Mailing Telephone | 6182401262 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | IL | Pharmacy Service Providers |
| Street Address |
1325 W 9TH ST |
| City | MOUNT CARMEL |
| State | IL |
| Zip Code | 62863-2906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265576193 | Michelle Lyn Daniel | Pharmacy Technician | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-16 |
| 1487255428 | Audra Keepes | Pharmacist | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2020-11-05 |
| 1427619865 | Houchens Express Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2019-06-26 |
| 1841335320 | Barbara Rexing | Pharmacist | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-21 |
| 1326182270 | Carol Sue Overton | Pharmacy Technician | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-16 |
| 1528102548 | Zack L Robinson | Pharmacist | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295200319 | Beth Marie Fischer | Physician Assistant | 1527 College Dr., Mt. Carmel, IL 62863 | 2018-10-04 |
| 1386194744 | Kayla Marie Wilcox | Physician Assistant | 1527 College Drive, Mt. Carmel, IL 62863 | 2016-10-10 |
| 1144495961 | Karsten B Slater | Family Medicine | 1527 College Dr, Mount Carmel, IL 62863 | 2008-04-23 |
| 1417147760 | Keesha L. Peterson | Speech-Language Pathologist | 1418 College Drive, Physical Medicine Department, Mount Carmel, IL 62863 | 2007-08-01 |
| 1740488139 | Wabash Area Vocational Enterprises, Inc. | Day Training, Developmentally Disabled Services | 1420 West Third Street, Mt. Carmel, IL 62863 | 2007-07-06 |
| 1972649390 | David Ray Miller | Dentist | 325 East 13th Street, Mount Carmel, IL 62863 | 2007-01-30 |
| 1356406748 | Enrique V Bouffard IIi | Radiology | 326 West 3rd St, Mt Carmel, IL 62863 | 2006-12-26 |
| 1417028168 | General Baptist Nursing Home of Illinois | Skilled Nursing Facility | 1320 W. 9th Street, Mt. Carmel, IL 62863 | 2006-11-13 |
| 1316055130 | Richland Radiology Ltd | Clinic/Center | 326 W 3rd Street, Mount Carmel, IL 62863 | 2006-08-29 |
| 1760986392 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1418 College Dr, Mount Carmel, IL 62863 | 2018-03-20 |
| Find all providers in zip 62863 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265576193 | Michelle Lyn Daniel | Pharmacy Technician | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-16 |
| 1326182270 | Carol Sue Overton | Pharmacy Technician | 1325 W 9th St, Mount Carmel, IL 62863-2906 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616299 | Marina Bozovic | Pharmacy Technician | 2229 S Lexington Dr Apt 208, Mount Prospect, IL 60056-5959 | 2020-10-11 |
| 1124633094 | Lorena Sadiku | Pharmacy Technician | 9 Regent Ct, Oak Brook, IL 60523-1755 | 2020-09-08 |
| 1457966301 | Hoang Bich Thuy Tran | Pharmacy Technician | 496 Vaughn Cir, Aurora, IL 60502-6764 | 2020-09-08 |
| 1093320947 | David Li | Pharmacy Technician | 2848 S Quinn St Apt A, Chicago, IL 60608-5979 | 2020-09-08 |
| 1922612928 | Valentina Iliescu | Pharmacy Technician | 2440 N Luna Ave, Chicago, IL 60639-1335 | 2020-09-07 |
| 1972128486 | Peter Redden | Pharmacy Technician | 15232 S 82nd Ave, Orland Park, IL 60462-4116 | 2020-06-10 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1679029995 | Meghan Robbins | Pharmacy Technician | 10428 S. Springfield, Chicago, IL 60655 | 2016-08-28 |
| 1093185209 | Kristin Kalivoda | Pharmacy Technician | 2 N. Cass Avenue, Westmont, IL 60559 | 2015-09-30 |
| 1922498484 | Heather Boslem | Pharmacy Technician | 1016 Emerald Ln, Machesney Park, IL 61115-2130 | 2015-02-04 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT CARMEL |
| Zip Code | 62863 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.