MS. MARY JACOB (NPI# 1164774071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164774071 |
| Entity Type | Individual |
| Full Name | MS. MARY JACOB |
| Credential | RPH |
| Practice Address |
16 S Waukegan Rd Deerfield IL 60015-5216 |
| Practice Telephone | 8474984151 |
| Practice Fax Number | 8474989864 |
| Mailing Telephone | 8474984151 |
| Mailing Fax Number | 8474989864 |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051040128 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518425982 | Mary Deena Jacob | Nurse Practitioner | 2865 Mcdermott Rd #225, Plano, TX 75025 | 2019-03-05 |
| 1124537667 | Mary Jacob | Dentist | 334 Broadway, Revere, MA 02151-5016 | 2017-09-27 |
| 1225321755 | Mary Sunny Jacob | Emergency Medicine | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2011-05-17 |
| 1194741041 | Mary Ann Jacob | Pediatrics | 2841 Debarr Rd, Suite 45, Anchorage, AK 99508-2932 | 2006-07-14 |
| 1396776571 | Mary R Jacob | Clinical Nurse Specialist | 1600 S Orlando Ave, Winter Park, FL 32789-5547 | 2006-07-05 |
| 1659348399 | Mary Anne Jacob | Obstetrics & Gynecology | 6545 France Avenue South, Suite 540, Edina, MN 55435 | 2006-03-01 |
| 1083612246 | Mary Casey Jacob | Psychologist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-07-12 |
| Street Address |
16 S WAUKEGAN RD |
| City | DEERFIELD |
| State | IL |
| Zip Code | 60015-5216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700832193 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 16 S Waukegan Rd, Deerfield, IL 60015 | 2006-05-26 |
| 1376992602 | Charles Bechler | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2016-06-07 |
| 1285082495 | Constantine C Heotis | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2016-05-27 |
| 1780031252 | Silvena Landup | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2016-05-15 |
| 1669651584 | Sophie Gelman | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2007-10-26 |
| 1871713719 | Marcus Kim | Pharmacist | 16 S Waukegan Rd, Deerfield, IL 60015-5216 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073569 | Steven A Ditgen | Physical Therapist | 43 N. Waukegan Road, Deerfield, IL 60015 | 2020-04-29 |
| 1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
| 1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1528628484 | Cynthia Lynne Mckinzie | Psychologist | The Neuroscience Center, 440 Lake Cook Road, Deerfield, IL 60015 | 2019-06-13 |
| 1073084497 | Mary Jeane Jeane Velez | Nurse Practitioner | Brentwood Rehabilitation Center, 3705 Deerfield Rd., Deerfield, IL 60015 | 2018-12-11 |
| 1891264644 | Smile On of North Shore, PC | Dentist | 707 Lake Cook Rd., Suite 121, Deerfield, IL 60015 | 2018-11-21 |
| 1497236376 | Linda Li | Counselor | 15 Parkway North Blvd, Deerfield, IL 60015 | 2018-08-28 |
| 1174009831 | Rachael Michelle Lynn | Physician Assistant | 1302 Hazel Ave, Deerfield, IL 60015 | 2018-07-16 |
| 1730675182 | Alexandra Lee Joseph | Social Worker | 420 Lake Cook Road, Suite 113, Deerfield, IL 60015 | 2018-07-09 |
| Find all providers in zip 60015 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992324156 | Nicholas Simon | Pharmacist | 1525 Lake Cook Rd Apt 231, Deerfield, IL 60015-5297 | 2020-04-08 |
| 1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
| 1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
| 1538629688 | Natasha Farah Polster | Pharmacist | 200 Wilmot Rd # Ms -2287, Deerfield, IL 60015-4620 | 2019-03-24 |
| 1437677705 | Nona Gayle Decastro | Pharmacist | 1 Baxter Pkwy # Df41e, Deerfield, IL 60015-4625 | 2017-09-06 |
| 1073895058 | Lisa Jane Wiesner | Pharmacist | 302 Wilmot Rd # 3268, Deerfield, IL 60015-4618 | 2011-09-15 |
| 1629382841 | Gyula J Nadas | Pharmacist | 302 Wilmot Rd, Deerfield, IL 60015-4614 | 2010-07-29 |
| 1538387386 | Steven Carl Anderson | Pharmacist | 47 Nottingham Rd, Deerfield, NH 03037-1532 | 2007-04-24 |
| 1407975568 | Nneka Cos-okpalla | Pharmacist | 1415 Lake Cook Road, Ms L#444, Deerfield, IL 60015-5238 | 2007-03-28 |
| 1346364353 | Yelena Silber | Pharmacist | 1015 Springfield Ave, Deerfield, IL 60015-3030 | 2007-03-16 |
| Find all providers in DEERFIELD | ||||
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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.