DR. MICHAEL POULSEN (NPI# 1770863243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770863243 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL POULSEN |
| Credential | PHARMD |
| Practice Address |
1201 E State St Rockford IL 61104-2212 |
| Practice Telephone | 8159622812 |
| Practice Fax Number | 8159623259 |
| Mailing Telephone | 8159622812 |
| Mailing Fax Number | 8159623259 |
| Enumeration Date | 2011-08-27 |
| Last Update Date | 2011-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051.291210 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477094332 | Michael Poulsen | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2017-03-13 |
| Street Address |
1201 E STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467467654 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1201 E State St, Rockford, IL 61104-2212 | 2006-07-29 |
| 1609483601 | Peter Drew Clarke II | Pharmacist | 1201 E State St, Rockford, IL 61104-2212 | 2020-09-24 |
| 1578175899 | Edward Loy | Pharmacist | 1201 E State St, Rockford, IL 61104-2212 | 2020-08-18 |
| 1104107796 | Walgreens | Pharmacy | 1201 E State St, Rockford, IL 61104-2212 | 2011-09-08 |
| 1275814774 | Amanda Mclellan | Pharmacist | 1201 E State St, Rockford, IL 61104-2212 | 2011-08-29 |
| 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.