DR. KERI LYNN WILLOUGHBY (NPI# 1619231503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619231503 |
| Entity Type | Individual |
| Full Name | DR. KERI LYNN WILLOUGHBY |
| Credential | PHARM.D. |
| Practice Address |
209 9th St Suite 200 Rockford IL 61104-2235 |
| Mailing Address |
11653 Waidi Ave Machesney Park IL 61115-1032 |
| Practice Telephone | 8154905871 |
| Mailing Telephone | 8154043300 |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-06-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 18251 | NV | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 051.292879 | IL | Pharmacy Service Providers |
| Street Address |
209 9TH ST SUITE 200 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639104359 | Alta L Ryan | Nurse Practitioner | 209 9th St, Suite 200, Rockford, IL 61104-2235 | 2006-07-11 |
| 1689139388 | Amy Wedel | Occupational Therapist | 209 9th St, Rockford, IL 61104-2235 | 2019-02-06 |
| 1538631114 | Samantha Elizabeth Wagner | Nurse Practitioner | 209 9th St, Rockford, IL 61104-2235 | 2018-12-20 |
| 1548754591 | Jessica Lee Driscoll | Physical Medicine & Rehabilitation | 209 9th St, Rockford, IL 61104-2235 | 2018-06-21 |
| 1346733953 | Amy L Carter | Physical Medicine & Rehabilitation | 209 9th St, Rockford, IL 61104-2235 | 2018-06-08 |
| 1659864312 | Jered Andrew Hartman | Physical Therapist | 209 9th St, Rockford, IL 61104-2235 | 2018-06-07 |
| 1669965463 | Betty Lynn Downing | Physical Therapy Assistant | 209 9th St, Rockford, IL 61104-2235 | 2018-06-07 |
| 1679066336 | Kristin Crowell Hatch | Occupational Therapist | 209 9th St, Rockford, IL 61104-2235 | 2018-06-07 |
| 1881187565 | Ray Peregrino | Physical Therapist | 209 9th St, Rockford, IL 61104-2235 | 2018-06-07 |
| 1801272836 | Laurie Hasken | Registered Nurse | 209 9th St, Suite 200, Rockford, IL 61104 | 2015-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| 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 |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1447875604 | Paulushi Patel | Pharmacist | 2013 Mcfarland Rd, Rockford, IL 61107-6835 | 2020-06-13 |
| 1174009765 | Lynn Carlson | Pharmacist | 1672 Peconic Pl, Rockford, IL 61108-7033 | 2018-07-17 |
| 1700374568 | Zarin F Haider | Pharmacist | 2662 Elmwood Rd Ste 101, Rockford, IL 61103-1573 | 2018-04-27 |
| 1932624400 | Desmond Anthony Harold | Pharmacist | 250 Marcell Dr Ne Apt 9, Rockford, MI 49341-1380 | 2017-08-07 |
| 1528503216 | Miles Skalnek | Pharmacist | 511 10 Mile Road, Rockford, MI 49341 | 2017-01-04 |
| 1629526421 | Chi Zhang | Pharmacist | 8628 Blue River Rd, Rockford, IL 61107-5304 | 2016-09-21 |
| 1255701595 | Patrick Donohoo | Pharmacist | 291 Bienterra Trl Apt 5, Rockford, IL 61107-5890 | 2015-09-29 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1801234224 | David Thomas Storm | Pharmacist | 4404 E State St, Suite 402, Rockford, IL 61108-2115 | 2013-06-07 |
| Find all providers in ROCKFORD | ||||
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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.