DR. JACOB BACKHOFF (NPI# 1639572563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639572563 |
| Entity Type | Individual |
| Full Name | DR. JACOB BACKHOFF |
| Credential | PHARMD |
| Practice Address |
101 W University Ave Ste 102 Champaign IL 61820-3909 |
| Practice Telephone | 2173661278 |
| Practice Fax Number | 2173666897 |
| Mailing Telephone | 2173661278 |
| Mailing Fax Number | 2173666897 |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2014-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051297980 | IL | Pharmacy Service Providers |
| Street Address |
101 W UNIVERSITY AVE STE 102 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-3909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102969 | Tamara G Helfer | Specialist | 101 W University Ave, Champaign, IL 61820-3981 | 2005-05-23 |
| 1659984540 | Brickston Mellinger | Pharmacist | 101 W University Ave, Champaign, IL 61820-3909 | 2020-08-28 |
| 1477166841 | Amit Patel | Pharmacist | 101 W University Ave, Champaign, IL 61820-3909 | 2020-08-26 |
| 1790320802 | Amy Beth Kutska | Physician Assistant | 101 W University Ave, Champaign, IL 61820-3981 | 2019-11-12 |
| 1093274912 | Alicia Jo Crabtree | Advanced Practice Midwife | 101 W University Ave, Champaign, IL 61820-3981 | 2019-03-19 |
| 1396231767 | Lauren Ashleigh Frerichs | Nurse Practitioner | 101 W University Ave, Champaign, IL 61820-3909 | 2018-07-09 |
| 1700337474 | Annelise Smith | Advanced Practice Midwife | 101 W University Ave, Champaign, IL 61820-3909 | 2016-10-18 |
| 1750836300 | Lindsay Bustle | Advanced Practice Midwife | 101 W University Ave, Champaign, IL 61820-3981 | 2016-08-23 |
| 1922459650 | Kathryn Corgan Mitchell | Physician Assistant | 101 W University Ave, Champaign, IL 61820 | 2016-06-23 |
| 1730580572 | Stephanie Zuber | Physician Assistant | 101 W University Ave, Champaign, IL 61820-3909 | 2014-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| 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 |
|---|---|---|---|---|
| 1801419809 | Ritika Chopra | Pharmacist | 2906 Stanley Ln, Champaign, IL 61822-1123 | 2020-05-26 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1154698827 | Nahid Rajaee Behbahani | Pharmacist | 4713 Stonebridge Dr, Champaign, IL 61822-3512 | 2011-11-24 |
| 1003191891 | Nazli Siddiqui | Pharmacist | 2506 Fields South Dr Apt 201, Champaign, IL 61822-3714 | 2011-10-12 |
| 1649592015 | Julie D. Bickers | Pharmacist | 3114 Village Office Pl, Champaign, IL 61822-7680 | 2010-02-25 |
| 1982938577 | Rajul Gandhi | Pharmacist | 2402 Village Green Place, Walgreens Pharmacy, Champaign, IL 61822-3512 | 2009-09-29 |
| 1518100866 | Michael F Smiricky | Pharmacist | 1211 Sussex Ct, Champaign, IL 61821-6918 | 2009-04-16 |
| 1063676112 | Bruce A Strike | Pharmacist | 1801 W Windsor Road, Champaign, IL 61822 | 2008-07-17 |
| 1326263013 | Dien Van-the | Pharmacist | 714 Krebs Dr, Champaign, IL 61822-1103 | 2007-04-16 |
| Find all providers in CHAMPAIGN | ||||
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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.