MR. BENJAMIN DAVID BLITZBLAU (NPI# 1699097865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699097865 |
| Entity Type | Individual |
| Full Name | MR. BENJAMIN DAVID BLITZBLAU |
| Credential | PHARMD |
| Practice Address |
1515 E Riverside Blvd Kmart Pharmacy Loves Park IL 61111-4742 |
| Practice Telephone | 8158778059 |
| Practice Fax Number | 8152824992 |
| Mailing Telephone | 8158778059 |
| Mailing Fax Number | 8152824992 |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
051290077 | IL | Pharmacy Service Providers |
| Street Address |
1515 E RIVERSIDE BLVD KMART PHARMACY |
| City | LOVES PARK |
| State | IL |
| Zip Code | 61111-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780734061 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 1515 E Riverside Blvd, Loves Park, IL 61111-4742 | 2007-01-11 |
| 1538491873 | Helga Drinka | Pharmacist | 1515 E Riverside Blvd, Kmart Pharmacy, Loves Park, IL 61111-4742 | 2010-02-11 |
| 1760413819 | Kmart Stores of Illinois LLC | Pharmacy | 1515 E Riverside Blvd, Loves Park, IL 61111-4742 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316562788 | Salli Jacobsen | Technician | 6699 Torch Lite Tr, Loves Park, IL 61111 | 2020-06-11 |
| 1003476425 | Costco Wholesale Corporation | Pharmacy | 5000 Stadium Drive, Loves Park, IL 61111 | 2019-06-18 |
| 1427541077 | Ronit Golan | Physical Therapist | 4401 Peak Dr Ste 1, Loves Park, IL 61111 | 2018-06-08 |
| 1598049025 | Sara Debelak | Developmental Therapist | 7225 Golden Eagle Drive, Loves Park, IL 61111 | 2011-10-03 |
| 1083906382 | Gagandeep Goyal | Anesthesiology | 5504 N 2nd St, Loves Park, IL 61111 | 2011-05-05 |
| 1124354261 | Asap Transport, LLC | Taxi | 7117 Clinton Rd, Suite 4, Loves Park, IL 61111 | 2009-10-25 |
| 1235212275 | Roger H Hill | Optometrist | 4301 N Mulford Rd, Loves Park, IL 61111 | 2006-10-23 |
| 1831104546 | Pointcore, Inc. | Pharmacy | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2006-07-30 |
| 1629099627 | Lisa A. Breisch | Counselor | Harmony Center for Holistic Psychotherapy, 6625 N. 2nd Street, Loves Park, IL 61111 | 2006-07-22 |
| 1386670529 | Joseph L Digirolamo | Chiropractor | 116 East Riverside Blvd, Loves Park, IL 61111 | 2006-06-22 |
| Find all providers in zip 61111 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1740647767 | William Patrick Johnson Jr. | Pharmacist | 505 Jeffrey Pine Ct, O Fallon, IL 62269-2554 | 2016-01-21 |
| 1114382314 | Archariya Puangampai | Pharmacist | 4178 S Emerald Ave, Chicago, IL 60609-2645 | 2015-12-15 |
| 1285000992 | Dana Christine Losch | Pharmacist | 9000 W Golf Rd, Niles, IL 60714-5805 | 2015-08-17 |
| 1083013874 | Erin E Gianaras | Pharmacist | 2500 S Philo Rd, Urbana, IL 61802 | 2014-08-18 |
| 1033520705 | Donald Lellish | Pharmacist | 815 N. Randall Rd, Elgin, IL 60123 | 2014-05-15 |
| 1649680505 | Amanda E Gorman | Pharmacist | 14169 S Bell Rd, Homer Glen, IL 60491-8464 | 2014-05-01 |
| 1346650231 | Chayani Pam Kaenkumchorn | Pharmacist | 11305 W Lincoln Hwy, Mokena, IL 60448-2070 | 2014-05-01 |
| 1245640242 | Allison Ostrander | Pharmacist | 7111 Cermak Rd, Berwyn, IL 60402-2145 | 2014-04-30 |
| Find all providers with the same taxonomy | ||||
| City | LOVES PARK |
| Zip Code | 61111 |
Please comment or provide details below to improve the information on MR. BENJAMIN DAVID BLITZBLAU.
| 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.