PATRICK NDIBE MOGBO (NPI# 1417230707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417230707 |
| Entity Type | Individual |
| Full Name | PATRICK NDIBE MOGBO |
| Credential | PHARM.D. |
| Practice Address |
1050 N Kennedy Dr Kankakee IL 60901-2033 |
| Practice Telephone | 8159329615 |
| Practice Fax Number | 8159329140 |
| Mailing Telephone | 8159329615 |
| Mailing Fax Number | 8159329140 |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051293629 | IL | Pharmacy Service Providers |
| Street Address |
1050 N KENNEDY DR |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598772592 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2006-08-02 |
| 1033488234 | Michael C Olimene | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-12-19 |
| 1639446206 | Adnan Ebrahim | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-11-25 |
| 1942584743 | Mark James Murray | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-09-29 |
| 1396028494 | Asmita Patel | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-09-25 |
| 1770866105 | Ralph Lee Levange | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-09-21 |
| 1730462219 | Kenneth G Long | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-09-21 |
| 1104009083 | Thomas Patrick Fosnaugh | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2007-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| 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 |
|---|---|---|---|---|
| 1114202785 | Kyle L Miller | Pharmacist | 1700 E Court St, Kankakee, IL 60901-2671 | 2011-10-14 |
| 1437432747 | Vicki Jean Huber | Pharmacist | 1073 N Western Hills Dr, Kankakee, IL 60901-7482 | 2011-09-22 |
| 1700487121 | Alexis G Mcconkey | Pharmacist | 505 Riverstone Pkwy, Kankakee, IL 60901-7207 | 2020-11-03 |
| 1578163457 | David Leneil Troupe | Pharmacist | 505 Riverstone Pkwy, Kankakee, IL 60901-7207 | 2020-10-29 |
| 1013539683 | Megan L Lucas | Pharmacist | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-05-17 |
| 1801366240 | Danielle D Nunley | Pharmacist | 446 S Washington Ave, Kankakee, IL 60901-3744 | 2018-11-28 |
| 1396274403 | Erica Ternig-greco | Pharmacist | 500 N Wall St Ste C100, Kankakee, IL 60901-2942 | 2017-06-12 |
| 1720435894 | Matthew Kline | Pharmacist | 446 S Washington Ave, Kankakee, IL 60901-3744 | 2016-05-18 |
| 1255737300 | Antonio Burrowes Jr. | Pharmacist | 446 S Washington Ave, Kankakee, IL 60901-3744 | 2014-11-17 |
| 1578971560 | Richard Fosen | Pharmacist | 505 Riverstone Pkwy, Kankakee, IL 60901-7207 | 2014-07-23 |
| Find all providers in KANKAKEE | ||||
Please comment or provide details below to improve the information on PATRICK NDIBE MOGBO.
| 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.