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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051030452 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669823043 | Mark Doherty | Behavioral Analyst | 7 Bishop St, Framingham, MA 01702-8323 | 2016-06-27 |
| 1194818872 | Mark E Doherty | Dentist | 1155 Purchase St., New Bedford, MA 02740 | 2006-10-02 |
| 1952400079 | Mark Robert Doherty | Dentist | 26 Surfside Rd, Pryor, OK 74361-3306 | 2006-09-22 |
| 1801892260 | Mark J. Doherty | Dermatology | 1151 Ellis St Ste 202, Bellingham, WA 98225-5203 | 2005-06-21 |
| 1144862822 | Mark Doherty | Massage Therapist | 623 Broadway, Massapequa, NY 11758-5027 | 2019-10-14 |
| 1285696674 | Mark Doherty | Oral & Maxillofacial Surgery | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2006-04-03 |
| 1467423871 | Mark Gerard Doherty | Obstetrics & Gynecology | 1625 N George Mason Dr, Suite 475, Arlington, VA 22205-3683 | 2006-02-01 |
| Street Address |
120 E MAIN ST |
| City | STREATOR |
| State | IL |
| Zip Code | 61364-2901 |
| 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 |
| 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 |
| Find all providers in zip 61364 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.