JEFF ENGWALL (NPI# 1679174973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679174973 |
| Entity Type | Individual |
| Full Name | JEFF ENGWALL |
| Credential | RPH |
| Practice Address |
359 Knox Square Drive Galesburg IL 61401 |
| Mailing Address |
420 Fyre Lake Dr Sherrard IL 61281-9324 |
| Practice Telephone | 3093442254 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051.037766 | IL | Pharmacy Service Providers |
| Street Address |
359 KNOX SQUARE DRIVE |
| City | GALESBURG |
| State | IL |
| Zip Code | 61401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861962441 | Becky Cameron | Counselor | 2323 Windish Dr., Galesburg, IL 61401 | 2018-11-27 |
| 1295245496 | Aaron Thomas Wachtel | Dentist | 1172 Monroe Street, Galesburg, IL 61401 | 2017-10-03 |
| 1588182224 | Alicia Warren | Speech-Language Pathologist | 932 Harrison St., Galesburg, IL 61401 | 2017-09-01 |
| 1770986770 | Virginia G Kasser | Psychologist | 575 N Kellogg, Galesburg, IL 61401 | 2014-10-03 |
| 1063814309 | Lakshmi Kalyani Gudavalli | Physical Therapist | 275 E Carl Sandburg Drive, Marigold Rehabilitation, Galesburg, IL 61401 | 2014-09-18 |
| 1821350489 | James Eugene Tiller | Psychologist | 2101 Windish Drive, Galesburg, IL 61401 | 2012-06-11 |
| 1720285836 | Donald J. Regnier | Hearing Instrument Specialist | 4l Plaza, Suite 57, Galesburg, IL 61401 | 2007-07-02 |
| 1306066535 | Arnold John Minor | Dentist | 69 N Chambers St, Galesburg, IL 61401 | 2007-04-30 |
| 1114140373 | Community Residential Centers Inc | Intermediate Care Facility, Mentally Retarded | 239 S Cherry Street, Galesburg, IL 61401 | 2007-04-10 |
| 1508939794 | Mohammad Sami | Psychiatry & Neurology | 2323 Windish Drive, Bridgeway Inc, Galesburg, IL 61401 | 2006-11-16 |
| Find all providers in zip 61401 | ||||
| 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 |
|---|---|---|---|---|
| 1023409950 | Debra Weathers | Pharmacist | 2764 Springer Rd Apt 15, Galesburg, IL 61401-7515 | 2015-02-13 |
| 1992098404 | Terry Ray Walker | Pharmacist | 9880 E. Michigan Ave, Galesburg, MI 49053 | 2011-05-17 |
| 1801187992 | J David Goodlaxson | Pharmacist | 3033 Lincoln Park Dr, Galesburg, IL 61401-1127 | 2011-04-25 |
| 1619010295 | Barbara Jean Thomas | Pharmacist | 1178 Maple Ave, Galesburg, IL 61401-2634 | 2007-02-14 |
| 1689272031 | Barbara Barnewolt | Pharmacist | 2030 E Main St, Galesburg, IL 61401-5460 | 2020-10-16 |
| 1669070157 | Ayesha Brown | Pharmacist | 2030 E Main St, Galesburg, IL 61401-5460 | 2020-10-15 |
| 1730793316 | Natalie Johnson | Pharmacist | 844 W Fremont St, Galesburg, IL 61401-2509 | 2020-09-01 |
| 1578175394 | Trent M Pedigo | Pharmacist | 1057 E Main St, Galesburg, IL 61401-3973 | 2020-08-21 |
| 1649882176 | Aaron Jevon Morris | Pharmacist | 844 W Fremont St, Galesburg, IL 61401-2509 | 2020-08-17 |
| 1316558083 | Victoria Grace Jackson | Pharmacist | 844 W Fremont St, Galesburg, IL 61401-2509 | 2020-08-14 |
| Find all providers in GALESBURG | ||||
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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.