KOURTNEY FERMANICH (NPI# 1679088124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679088124 |
| Entity Type | Individual |
| Full Name | KOURTNEY FERMANICH |
| Credential | PHARM D |
| Practice Address |
816 Featherstone Rd Rockford IL 61107-6300 |
| Mailing Address |
4704 Rainbow Rdg Rockford IL 61109-3536 |
| Practice Telephone | 8152270081 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
051.300555 | IL | Pharmacy Service Providers |
| Street Address |
816 FEATHERSTONE RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033177589 | Madison Vamc | Department of Veterans Affairs (VA) Pharmacy | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2006-05-03 |
| 1952941833 | Amanda J Fruen | Nurse Practitioner | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2020-01-08 |
| 1770126187 | Daniel Kickertz | Pharmacist | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-10-18 |
| 1568027365 | Jan Lori Vogeler | Counselor | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-05-07 |
| 1285298901 | Kahseem Edward Ward | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-04-29 |
| 1659843852 | Melissa Lynn | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-12-28 |
| 1124590906 | Aimee Michelle Jerding | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-12-18 |
| 1174004998 | Jessica Mari Syversen | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-08-29 |
| 1033627526 | Tavares Moore | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-01-18 |
| 1386195634 | Sarah Ostrum | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2016-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154807147 | Brenda Marie Tanker | Pharmacist | 2642 Charles St, Rockford, IL 61108-1671 | 2018-07-13 |
| 1205326063 | Angela Considine | Pharmacist | 1401 E State St, Rockford, IL 61104-2315 | 2018-05-16 |
| 1306225651 | Jessica Benzer | Pharmacist | 6050 Northland Dr Ne, Suite 200, Rockford, MI 49341-9256 | 2015-05-20 |
| 1275832040 | Kirk A Schubert | Pharmacist | 1401 E State St, Emergency Department, Rockford, IL 61104-2315 | 2011-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392223 | Michelle To | Pharmacist | 2252 Aster Ct, Naperville, IL 60565-8893 | 2020-09-29 |
| 1760099253 | Kelsey Schultz | Pharmacist | 1058 N Paulina St Apt 2, Chicago, IL 60622-3918 | 2020-09-28 |
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1578176061 | Omolara Akintilo | Pharmacist | 3254 Toulouse, Bourbonnais, IL 60914-4554 | 2020-08-25 |
| 1972120285 | Susan F. Michaelis | Pharmacist | 405 W South St, Arlington Heights, IL 60005-1703 | 2020-07-02 |
| 1730701392 | Alexander Tam-phan Nguyen | Pharmacist | 773 N Silver Leaf Ln, Round Lake, IL 60073-5267 | 2020-05-17 |
| 1336769074 | Shakeel Ahmed | Pharmacist | 1471 E Business Center Dr Ste 500, Mt Prospect, IL 60056-6082 | 2020-04-22 |
| 1780214668 | Rikii A Pyle | Pharmacist | 1704 W Deyoung St, Marion, IL 62959-1054 | 2020-01-20 |
| 1629608773 | Madeline Lea Taitt | Pharmacist | 3637 Herrin Rd, Carterville, IL 62918-3156 | 2020-01-16 |
| 1235769464 | Joshua David Chady | Pharmacist | 550 E Industrial Park Rd, Murphysboro, IL 62966-3947 | 2020-01-15 |
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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.