MEDCENTRIX INC. (NPI# 1487829990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487829990 |
| Entity Type | Organization |
| Organization Name | MEDCENTRIX INC. |
| Other Organization Name | INGALLS PRO PHARM LL |
| Practice Address |
6701 159th St Tinley Park IL 60477-1758 |
| Practice Telephone | 7089157550 |
| Practice Fax Number | 7089157507 |
| Mailing Telephone | 7089157550 |
| Mailing Fax Number | 7089157507 |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |
| Authorized Official Name | MR. RONALD J. RUTKOWSKI (PHARMACY MANAGER) |
| Authorized Official Telephone | 7089157550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054015155 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 363374008002 | 05 |
| Other Name | Type Code |
|---|---|
| Ingalls Pro Pharm ll | Doing Business As Name - Organization |
| Street Address |
6701 159TH ST |
| City | TINLEY PARK |
| State | IL |
| Zip Code | 60477-1758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027651 | Frank J. Kniffen | Anesthesiology | 6701 159th St, Ingalls Same Day Surgery, Tinley Park, IL 60477-1758 | 2005-07-18 |
| 1659878635 | Lena Modieh | Nurse Practitioner | 6701 159th St, Tinley Park, IL 60477 | 2018-04-06 |
| 1740664630 | Annette Krapil | Pharmacist | 6701 159th St, Tinley Park, IL 60477-1758 | 2015-07-10 |
| 1063844934 | Primary Healthcare Associates, Sc | Non-Pharmacy Dispensing Site | 6701 159th St, Suite 1, Tinley Park, IL 60477-1758 | 2013-08-02 |
| 1154675700 | Donald A Williams Jr. | Physical Therapist | 6701 159th St, Tinley Park, IL 60477-1758 | 2012-11-05 |
| 1982953881 | Elizabeth Gezaw | Physical Therapist | 6701 159th St, Tinley Park, IL 60477-1758 | 2012-09-06 |
| 1477747939 | Associated Urological Specialists LLC | Radiology | 6701 159th St, Tinley Park, IL 60477-1758 | 2007-08-28 |
| 1669687307 | James Alfred Wallace | Internal Medicine | 6701 159th St, Suite 1, Tinley Park, IL 60477-1758 | 2007-05-14 |
| 1134257801 | Walid Kandah | Emergency Medicine | 6701 159th St, Tinley Park, IL 60477-1758 | 2007-03-02 |
| 1467588061 | Amjad Akhtar | Emergency Medicine | 6701 159th St, Tinley Park, IL 60477-1758 | 2007-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522366 | Joshua Gruenke | Physical Therapist | 17129 S. Harlem Avenue, Tinley Park, IL 60477 | 2020-09-14 |
| 1881229656 | Sherrie Lynn Tsang | Massage Therapist | 7925 West 171st Street, Tinley Park, IL 60477 | 2020-03-11 |
| 1437782117 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 17129 S Harlem Ave. Ste B3, Tinley Park, IL 60477 | 2020-02-20 |
| 1356998561 | Rasa Vaskeviciute | Physical Therapist | 17129 So Harlem, Tinley Park, IL 60477 | 2019-08-22 |
| 1538728258 | Michelle Anne Wisen | Physical Therapy Assistant | 17129 South Harlem, Suite B3, Tinley Park, IL 60477 | 2019-06-06 |
| 1073006151 | Danielle Lyon | Counselor | 6801 West 180th Court, Tinley Park, IL 60477 | 2018-06-13 |
| 1316445794 | Yvonne Tran | Physical Therapist | 17129 S Harlem Ave, Tinley Park, IL 60477 | 2018-01-31 |
| 1326574591 | Nicholas Barker | Chronic Disease Hospital | 7859 Joliet Drive North, Tinley Park, IL 60477 | 2017-05-10 |
| 1982063632 | Nicole Kristine Demarco | Specialist/Technologist | 16317 Clark Ln, Tinley Park, IL 60477 | 2016-02-22 |
| 1376900571 | Ucp Seguin Greater Chicago | Foster Care Agency | 7550 W. 183rd, Tinley Park, IL 60477 | 2016-01-20 |
| Find all providers in zip 60477 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740365782 | Walter Lagestee Incorporated | Pharmacy | 16039 Harlem Ave, Tinley Park, IL 60477-1611 | 2006-10-26 |
| 1932442209 | South Star Plus Pharmacy | Pharmacy | 16650 Harlem Ave, Tinley Park, IL 60477-1847 | 2013-04-04 |
| 1831454347 | Discount Drugs Inc | Pharmacy | 16650 Harlem Ave, Tinley Park, IL 60477-1847 | 2012-07-10 |
| 1699825786 | Ingalls Prof Pharmacy Ll | Pharmacy | 6701 159th St, Tinley Park, IL 60477-1758 | 2007-01-11 |
| 1154481588 | Du Page Medical Group Ltd | Pharmacy | 17495 La Grange Rd, Tinley Park, IL 60487-7581 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
| City | TINLEY PARK |
| Zip Code | 60477 |
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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.