ROBERT KOERT RENNECKER (NPI# 1477164473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477164473 |
| Entity Type | Individual |
| Full Name | ROBERT KOERT RENNECKER |
| Credential | BS |
| Practice Address |
555 N Main St Canton IL 61520-1829 |
| Mailing Address |
16059 E Cr 900n Kilbourne IL 62655-6541 |
| Practice Telephone | 3096477610 |
| Mailing Telephone | 3092562951 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051034424 | IL | Pharmacy Service Providers |
| Street Address |
555 N MAIN ST |
| City | CANTON |
| State | IL |
| Zip Code | 61520-1829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043687262 | Justin Freeman | Pharmacist | 555 N Main St, Canton, IL 61520-1829 | 2015-08-24 |
| 1740657097 | Jill Dyrda | Pharmacist | 555 N Main St, Canton, IL 61520-1829 | 2015-08-21 |
| 1528477718 | Matthew James Bartlett | Pharmacist | 555 N Main St, Canton, IL 61520-1829 | 2014-08-12 |
| 1326384124 | Namita Kamath | Pharmacist | 555 N Main St, Canton, IL 61520-1829 | 2012-12-25 |
| 1194000463 | Patrick Zimmerman | Pharmacist | 555 N Main St, Canton, IL 61520-1829 | 2011-10-18 |
| 1497839633 | Walgreen Co | Pharmacy | 555 N Main St, Canton, IL 61520-1829 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| Find all providers in zip 61520 | ||||
| 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 |
|---|---|---|---|---|
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1467084343 | Syed Ashraf Ali Shah | Pharmacist | 385 Westbourne Ct, Canton, MI 48188-4718 | 2020-02-07 |
| 1427680503 | Gracy Mathai-mathews | Pharmacist | 770 Pheasant Woods Dr, Canton, MI 48188-5224 | 2020-02-06 |
| 1962059378 | Catherine Lynn Denner | Pharmacist | 330 Oak Hill Ln, Canton, GA 30115-5433 | 2019-08-20 |
| 1427601806 | Tarek Mazloum | Pharmacist | 3815 Herbey St, Canton, MI 48188-2421 | 2019-07-24 |
| 1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
| 1063978260 | Jordan Richard Wanner | Pharmacist | 4615 Middlebranch Ave Ne, Canton, OH 44705-2960 | 2019-02-13 |
| 1861972333 | Brittany Carin Yu | Pharmacist | 2512 Tuscarawas St W, Canton, OH 44708-4702 | 2018-08-15 |
| 1598256364 | Austin Tull | Pharmacist | 2260 Holly Springs Pkwy Ste 180, Canton, GA 30115-9580 | 2018-05-28 |
| 1518491513 | Jerry Sherwin Vidis | Pharmacist | 41092 Northwind Dr, Canton, MI 48188-3115 | 2017-04-17 |
| Find all providers in CANTON | ||||
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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.