ABEBE FISSEHA (NPI# 1356994933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356994933 |
| Entity Type | Individual |
| Full Name | ABEBE FISSEHA |
| Practice Address |
3849 Northridge Dr Rockford IL 61114-4773 |
| Practice Telephone | 8156360333 |
| Practice Fax Number | 8156360149 |
| Mailing Telephone | 8155052943 |
| Mailing Fax Number | 8156360149 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051292525 | IL | Pharmacy Service Providers |
| Street Address |
3849 NORTHRIDGE DR |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114-4773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497772776 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2006-07-16 |
| 1659915163 | Orlandra Caldwell | Nurse Practitioner | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2019-10-29 |
| 1114569415 | Danielle Altepeter | Nurse Practitioner | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2019-10-09 |
| 1528100880 | Daniel H Pham, LLC. | Optometrist | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2007-02-13 |
| 1750463675 | Wal-mart Stores, Inc | Technician/Technologist | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2006-10-19 |
| 1558372524 | Daniel H Pham | Optometrist | 3849 Northridge Dr, Rockford, IL 61114-4773 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| 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 |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1447875604 | Paulushi Patel | Pharmacist | 2013 Mcfarland Rd, Rockford, IL 61107-6835 | 2020-06-13 |
| 1174009765 | Lynn Carlson | Pharmacist | 1672 Peconic Pl, Rockford, IL 61108-7033 | 2018-07-17 |
| 1700374568 | Zarin F Haider | Pharmacist | 2662 Elmwood Rd Ste 101, Rockford, IL 61103-1573 | 2018-04-27 |
| 1932624400 | Desmond Anthony Harold | Pharmacist | 250 Marcell Dr Ne Apt 9, Rockford, MI 49341-1380 | 2017-08-07 |
| 1528503216 | Miles Skalnek | Pharmacist | 511 10 Mile Road, Rockford, MI 49341 | 2017-01-04 |
| 1629526421 | Chi Zhang | Pharmacist | 8628 Blue River Rd, Rockford, IL 61107-5304 | 2016-09-21 |
| 1255701595 | Patrick Donohoo | Pharmacist | 291 Bienterra Trl Apt 5, Rockford, IL 61107-5890 | 2015-09-29 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1801234224 | David Thomas Storm | Pharmacist | 4404 E State St, Suite 402, Rockford, IL 61108-2115 | 2013-06-07 |
| Find all providers in ROCKFORD | ||||
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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.