Healthcare Provider Details
I. General information
NPI: 1831255108
Provider Name (Legal Business Name): FELKER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 W BLACKHAWK DR
BYRON IL
61010-8612
US
IV. Provider business mailing address
PO BOX 474
BYRON IL
61010-0474
US
V. Phone/Fax
- Phone: 815-234-5466
- Fax: 815-234-4709
- Phone: 815-234-5466
- Fax: 815-234-4709
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 054.011485 |
| License Number State | IL |
VIII. Authorized Official
Name:
THOMAS
E
FELKER
II
Title or Position: PHARMACY DIRECTOR/PIC
Credential:
Phone: 815-262-7276