DR. IRWIN DOUGLAS OBISPO (NPI# 1083262877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083262877 |
| Entity Type | Individual |
| Full Name | DR. IRWIN DOUGLAS OBISPO |
| Practice Address |
2500 W 95th St Evergreen Park IL 60805-2807 |
| Practice Telephone | 7082290892 |
| Practice Fax Number | 7082290914 |
| Mailing Telephone | 7082290892 |
| Mailing Fax Number | 7082290914 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051297247 | IL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 71-0415188 | 05 |
| Street Address |
2500 W 95TH ST |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-2807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578580874 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2500 W 95th St, Evergreen Park, IL 60805-2807 | 2006-07-16 |
| 1538683958 | Bobby Rajkumar Singh | Optometrist | 2500 W 95th St, Evergreen Park, IL 60805-2807 | 2017-07-27 |
| 1487095675 | Felicia Higgs-cooper | Pharmacist | 2500 W 95th St, Evergreen Park, IL 60805-2807 | 2013-07-16 |
| 1629267976 | Rasa Tamulavichus Od PC | Optometrist | 2500 W 95th St, Walmart Vision Center, Evergreen Park, IL 60805-2807 | 2007-10-22 |
| 1841375151 | Wal-mart Stores, Inc | Technician/Technologist | 2500 W 95th St, Evergreen Park, IL 60805-2807 | 2006-10-26 |
| 1427148725 | Rasa Tamulavichus | Optometrist | 2500 W 95th St, Walmart Vision Center, Evergreen Park, IL 60805-2807 | 2006-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| 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 |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1639577695 | Paula M Farina | Pharmacist | 2559 W 95th St, Evergreen Park, IL 60805-2809 | 2014-12-08 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1134729122 | Kimberly Denise Holmes | Pharmacist | 9400 S Western Ave, Evergreen Park, IL 60805-2509 | 2020-10-28 |
| 1831701556 | Hiba Masoud | Pharmacist | 3959 W 95th St, Evergreen Park, IL 60805-1904 | 2020-08-24 |
| 1932711975 | Jamal Jebreal | Pharmacist | 8700 S Kedzie Ave, Evergreen Park, IL 60805-1024 | 2020-08-20 |
| 1619589835 | Micky Patel | Pharmacist | 3959 W 95th St, Evergreen Park, IL 60805-1904 | 2020-08-19 |
| 1033721121 | Asmaa Ibrahim Mustafa | Pharmacist | 8700 S Kedzie Ave, Evergreen Park, IL 60805-1024 | 2020-08-19 |
| 1861931792 | Amro Atassi | Pharmacist | 2955 W 95th St, Evergreen Park, IL 60805-2409 | 2017-02-12 |
| Find all providers in EVERGREEN PARK | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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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.