ROBERT VINCENT MALICKI (NPI# 1952669145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952669145 |
| Entity Type | Individual |
| Full Name | ROBERT VINCENT MALICKI |
| Credential | RPH |
| Practice Address |
864 Heather Dr Bourbonnais IL 60914-1314 |
| Practice Telephone | 8159338585 |
| Mailing Telephone | 8159338585 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051-33532 | IL | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DOG TAG | 2569824 | 01 |
| Street Address |
864 HEATHER DR |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-1314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| 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 |
|---|---|---|---|---|
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1235640558 | Camille Crawford | Pharmacist | 333 William R Latham Sr Dr, Bourbonnais, IL 60914-1774 | 2017-10-13 |
| 1063013142 | Sihem Boulahbal | Pharmacist | 2080 N State Route 50, Bourbonnais, IL 60914-4410 | 2020-11-04 |
| 1396346862 | Joffin Abraham | Pharmacist | 2080 N State Route 50, Bourbonnais, IL 60914-4410 | 2020-11-02 |
| 1396369302 | Cody A Holler | Pharmacist | 655 Main St Nw, Bourbonnais, IL 60914-2303 | 2020-06-04 |
| 1578109823 | Bethany Rae Finn | Pharmacist | 633 Armour Rd, Bourbonnais, IL 60914-2077 | 2019-11-21 |
| 1649826660 | Tammy T Mcclellan | Pharmacist | 200 Riverside Dr, Bourbonnais, IL 60914-4689 | 2019-08-15 |
| 1427576909 | Jose Luis Ortiz Jr. | Pharmacist | 501 N Convent St, Bourbonnais, IL 60914-1329 | 2017-09-05 |
| 1134573256 | Joseph Scherer | Pharmacist | 655 Main St Nw, Bourbonnais, IL 60914-2303 | 2016-04-14 |
| 1366896508 | Karen Marie Strysik-weinert | Pharmacist | 655 Main St Nw, Bourbonnais, IL 60914-2303 | 2016-04-13 |
| Find all providers in BOURBONNAIS | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
Please comment or provide details below to improve the information on ROBERT VINCENT MALICKI.
| 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.