DR. JENNIFER L BROGAN (NPI# 1396987186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396987186 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER L BROGAN |
| Credential | PHARM.D |
| Practice Address |
3243 W 115th St Merrionette Park IL 60803-4555 |
| Practice Telephone | 7085974828 |
| Practice Fax Number | 7085978957 |
| Mailing Telephone | 7085974828 |
| Mailing Fax Number | 7085978957 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051291892 | IL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 363168270102 | 05 |
| Street Address |
3243 W 115TH ST |
| City | MERRIONETTE PARK |
| State | IL |
| Zip Code | 60803-4555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164871596 | Cassie Enders | Pharmacist | 3243 W 115th St, Merrionette Park, IL 60803-4555 | 2016-06-07 |
| 1609293539 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3243 W 115th St, Merrionette Park, IL 60803 | 2014-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699173013 | American Medical Lab, Ltd | Clinical Medical Laboratory | 5130 W 125th Pl, American Medical Lab, Alsip, IL 60803 | 2014-12-17 |
| 1225387574 | A Touch of Class Dentistry II | Dentist | 12033 S. Pulaski Road, Alsip, IL 60803 | 2012-08-31 |
| 1841431657 | George P. Danos Inc | Dentist | 5101 W 111th St, Alsip, IL 60803 | 2009-03-09 |
| 1194898114 | Vital Rehabilitation & Physical Therapy Inc | Clinic/Center | 11600 S Kedzie, Merrionette Park, IL 60803 | 2006-11-16 |
| 1841203650 | Alsip Dental Arts PC | Dentist | 11107 South Lawler, Alsip, IL 60803 | 2006-08-14 |
| 1477500932 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 12001 S Pulaski Rd, Alsip, IL 60803 | 2006-05-30 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 1467064360 | Yash Desai | Pharmacist | 12290 S Pulaski Rd, Alsip, IL 60803 | 2020-08-20 |
| 1114357092 | Abdul Hussein Darki | Pediatrics | 11808 S Pulaski Rd, Alsip, IL 60803 | 2013-11-14 |
| 1679603997 | Joseph Edward Statkus | Dentist | 11350 S Cicero Ave, Alsip, IL 60803 | 2007-03-06 |
| Find all providers in zip 60803 | ||||
| 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 |
|---|---|---|---|---|
| 1396249520 | Jenny Rosillo Macaso | Pharmacist | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2018-03-21 |
| 1164871596 | Cassie Enders | Pharmacist | 3243 W 115th St, Merrionette Park, IL 60803-4555 | 2016-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083414 | Cedomir Micic | Pharmacist | 1111 W 14th Pl Unit 126, Chicago, IL 60608-2796 | 2020-11-07 |
| 1831790674 | Cristopher Guzman | Pharmacist | 7122 40th St Ste 1, Stickney, IL 60402-5491 | 2020-11-06 |
| 1215538046 | Nancy Ann Blue | Pharmacist | 4101 N Vermilion St, Danville, IL 61834-5997 | 2020-11-06 |
| 1386245397 | Lynsey Perera | Pharmacist | 7610 N Orange Prairie Rd, Peoria, IL 61615-9324 | 2020-11-05 |
| 1629679899 | Rubegin F Torrevillas | Pharmacist | 731 Terry Rd, Glendale Heights, IL 60139-3330 | 2020-11-04 |
| 1730780214 | Rhonda Leigh Herrmann | Pharmacist | 13969 Moore Rd, Marion, IL 62959-6835 | 2020-11-03 |
| 1265033674 | Ghazala Raheel | Pharmacist | 4000 Route # 173, Zion, IL 60099 | 2020-11-03 |
| 1679174973 | Jeff Engwall | Pharmacist | 359 Knox Square Drive, Galesburg, IL 61401 | 2020-11-03 |
| 1609477280 | Marlene A Espinosa | Pharmacist | 2680 N, Il 83, Round Lake Beach, IL 60073 | 2020-11-02 |
| 1023619616 | Hetal Patel | Pharmacist | 3 S 100 Rt 53, Glen Ellyn, IL 60137 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
| City | MERRIONETTE PARK |
| Zip Code | 60803 |
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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.