MR. GREG PANKOW (NPI# 1871874305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871874305 |
| Entity Type | Individual |
| Full Name | MR. GREG PANKOW |
| Credential | PHARMACIST |
| Practice Address |
1775 Dempster St Ste T01116 Park Ridge IL 60068-1143 |
| Mailing Address |
200 Wilmot Road Deerfield IL 60015-2385 |
| Practice Telephone | 8476922184 |
| Practice Fax Number | 8476922467 |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2013-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
051-035336 | IL | Pharmacy Service Providers |
| Street Address |
1775 DEMPSTER ST STE T01116 |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| 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 |
|---|---|---|---|---|
| 1063689537 | Kelly Johnson | Pharmacist | 1775 Dempster St, Department of Pharmacy, Park Ridge, IL 60068-1143 | 2008-05-13 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
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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.