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1568786184 NPI number — WAYNE THOMAS GREGOIRE R.PH.

NPI Number: 1568786184
Health Care Provider/Practitioner: WAYNE THOMAS GREGOIRE R.PH.

Information about “1568786184” NPI (WAYNE THOMAS GREGOIRE R.PH.) exists in 1568786184 in HTML format HTML  |  1568786184 in plain Text format TXT  |  1568786184 in PDF (Portable Document Format) PDF  |  1568786184 in an XML format XML  formats.

NPI Number : 1568786184 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568786184",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREGOIRE",
    "FirstName": "WAYNE",
    "MiddleName": "THOMAS",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "R.PH.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1382 DEEP RUN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NAPERVILLE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60540-7025",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-420-9884",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1199 E OGDEN AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NAPERVILLE",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60563-8568",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "630-357-7757",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/25/2010",
    "LastUpdateDate": "03/25/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "051.031602",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "26013943A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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