MR. MARK THOMAS DOHERTY


Address: 120 E Main St, Streator, IL 61364-2901
Phone: 8156732439

MR. MARK THOMAS DOHERTY (NPI# 1497038145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497038145
Entity Type Individual
Full Name MR. MARK THOMAS DOHERTY
Credential RPH
Practice Address 120 E Main St
Streator
IL 61364-2901
Mailing Address 1210 W Madison St
Ottawa
IL 61350-2567
Practice Telephone 8156732439
Mailing Telephone 8154332055
Enumeration Date 2011-09-20
Last Update Date 2011-09-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist 051030452 IL Pharmacy Service Providers

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1285696674 Mark Doherty Oral & Maxillofacial Surgery 1353 Dorchester Ave, Dorchester, MA 02122-2932 2006-04-03
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Office Location

Street Address 120 E MAIN ST
City STREATOR
State IL
Zip Code 61364-2901

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972970291 Meghan Hatzer Pharmacist 120 E Main St, Streator, IL 61364-2901 2015-08-24
1124308796 Cara Rothrock Pharmacist 120 E Main St, Streator, IL 61364-2901 2011-08-26
1881609030 Walgreen Co Durable Medical Equipment & Medical Supplies 120 E Main St, Streator, IL 61364-2901 2006-07-29

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093110066 Ottawa Friendship House Work Activity Center, Inc Intermediate Care Facility, Mentally Retarded 600 West 12th Street, Streator, IL 61364 2014-11-03
1306278973 Robert Henry Harms Veterinarian 701 Oakley Ave, Streator, IL 61364 2013-08-06
1518202373 Jessica L Hartman Nurse Practitioner 2377 N Bloomington St, Streator, IL 61364 2012-12-05
1992049563 Wendell Allen Sargent Dentist 106 Boys St, Streator, IL 61364 2012-11-20
1215266036 Sudha Pravinkumar Internal Medicine 2377 Bloomington Ave, Ste B, Streator, IL 61364 2009-12-08
1497988984 Lifetime Medical Supply Inc. Durable Medical Equipment & Medical Supplies 1215 N Ottercreek Rd., Streator, IL 61364 2009-08-31
1275709727 Fresenius Medical Care of Illinois LLC Clinic/Center 2356 North Bloomington St, Streator, IL 61364 2008-05-05
1487701793 Tammy R Thieme Social Worker 17 North Point Plaza, Streator, IL 61364 2007-01-05
1629185376 Gary Finkelstein Md Eye Associates Sc Ophthalmology 102 West Elm Street, Streator, IL 61364 2006-08-25
1134150808 Indra Pal Mdsc Internal Medicine 104 Sixth Street, Streator, IL 61364 2006-07-05
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912511304 Jacob Casson Pharmacist 1422 E Elm St, Streator, IL 61364-2541 2020-09-02
1215573761 James Edward Parr Pharmacist 1348 E 16th Rd, Streator, IL 61364-8968 2019-11-20
1831476118 Ashley Marie Mcmullen Pharmacist 1364 E 1569th Rd, Streator, IL 61364-8900 2011-11-14
1164022547 Trent Ryan Weeks Pharmacist 2415 N Bloomington St, Streator, IL 61364-1305 2020-10-27
1396384285 John Sorensen Pharmacist 2399 N Bloomington St, Streator, IL 61364-1307 2019-12-26
1831735760 Jacob Thomas Kotecki Pharmacist 2399 N Bloomington St, Streator, IL 61364-1307 2019-11-26
1144878687 Tomas Garbaliauskas Pharmacist 2415 N Bloomington St, Streator, IL 61364-1305 2019-08-28
1972970291 Meghan Hatzer Pharmacist 120 E Main St, Streator, IL 61364-2901 2015-08-24
1124308796 Cara Rothrock Pharmacist 120 E Main St, Streator, IL 61364-2901 2011-08-26
1861416604 James R Broedlow Pharmacist 109 E Main St, Streator, IL 61364-2924 2006-07-26
Find all providers in STREATOR

Competitor

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City STREATOR
Zip Code 61364

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Dataset Information

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.

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