EDGAR AUF DEM GRABEN (NPI# 1336702125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336702125 |
| Entity Type | Individual |
| Full Name | EDGAR AUF DEM GRABEN |
| Practice Address |
100 N River Rd Ste G122 Des Plaines IL 60016-1209 |
| Mailing Address |
6493 N Northwest Hwy Apt 409 Chicago IL 60631-1892 |
| Practice Telephone | 8475810800 |
| Practice Fax Number | 8474104910 |
| Mailing Telephone | 7087744946 |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835G0303X |
Pharmacist Specialization: Geriatric |
054-035924 | IL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION | 054-035924 | 01 |
| Street Address |
100 N RIVER RD STE G122 |
| City | DES PLAINES |
| State | IL |
| Zip Code | 60016-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1407367022 | Vcare Pharmacy Inc | Pharmacy | 380 E Nortwest Hwy, Suite 201, Des Plaines, IL 60016 | 2017-10-23 |
| 1649799610 | George N Hotousiotis | Pharmacist | 10 East Golf Road, Des Plaines, IL 60016 | 2017-09-11 |
| 1619494838 | Abdul M Shamsuddin | Physical Therapist | 2555 Suffield St, Des Plaines, IL 60016 | 2017-08-28 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1902250178 | Perfect Storm Chiropractic, LLC | Chiropractor | 565 Concord Ln, Des Plaines, IL 60016 | 2016-04-14 |
| 1255796611 | Nektaria Goudis | Psychologist | 950 Lee Street, Des Plaines, IL 60016 | 2015-12-29 |
| 1831501352 | Gary R. Kuntz | Dentist | 1173 Algonquin Rd., Des Plaines, IL 60016 | 2014-06-02 |
| 1558773754 | Midwest Anesthesia and Pain Specialists, Sc | Pain Medicine | 9700 Golf Rd, Second Floor, Des Plaines, IL 60016 | 2014-05-22 |
| 1508282377 | Maciej Padowski | Emergency Medicine | 9500 Greenwood Dr, Des Plaines, IL 60016 | 2014-03-17 |
| Find all providers in zip 60016 | ||||
| Taxonomy Code | 1835G0303X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Geriatric |
| A pharmacist who is certified in geriatric pharmacy practice is designated as a "Certified Geriatric Pharmacist" (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly. |
| Notes: Source: Commission for Certification in Geriatric Pharmacy (www.ccgp.org) [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467969402 | Hilda Dolapo Hassan | Pharmacist | 2937 Shetland Ln, Montgomery, IL 60538-4104 | 2017-12-29 |
| 1578999348 | Ihuoma C Ozoh | Pharmacist | 18331 Mulberry Terrace, Country Club Hills, IL 60478 | 2013-09-24 |
| 1649619016 | Joel Jay Meyers | Pharmacist | 3107 W Jerome St, Chicago, IL 60645-1142 | 2013-06-19 |
| 1902249790 | Alfredo Villasenor | Pharmacist | 233 Berkshire Dr, Lake Villa, IL 60046-5051 | 2013-04-10 |
| 1730446881 | Bhupendra S Vyas | Pharmacist | 8001 N. Lincoln Ave # 800, C/o Rph On The Go Suite 800, Skokie, IL 60077 | 2012-04-13 |
| 1679848618 | Mark Sly | Pharmacist | 403 N Veterans Pkwy, Bloomington, IL 61704-7718 | 2012-03-08 |
| 1346521333 | Chhaya Patel | Pharmacist | 728 S Taylor Ave, Oak Park, IL 60304-1624 | 2011-09-02 |
| 1780988535 | Mark Norman Gravdal | Pharmacist | 297 Cascade Dr, Crystal Lake, IL 60012-3345 | 2011-01-07 |
| 1972827293 | Cindy Sue Porter | Pharmacist | 2150 N Lincoln Park W, #1411, Chicago, IL 60614-4652 | 2010-03-15 |
| 1104073600 | Rubin B Shah | Pharmacist | 10631 Grandview Dr, Palos Park, IL 60464-2580 | 2008-08-26 |
| Find all providers with the same taxonomy | ||||
| City | DES PLAINES |
| Zip Code | 60016 |
Please comment or provide details below to improve the information on EDGAR AUF DEM GRABEN.
| 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.