JACOB FREDERICKS
NPI 1356066120
Pharmacist in Springfield, IL

Active since October 05, 2022
3100 S MACARTHUR BLVD, SPRINGFIELD, IL 62704(217) 528-4926 Get Directions Write a Review

NPPES record last updated: October 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jacob Fredericks NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB FREDERICKS (NPI 1356066120) is an individual pharmacist in Springfield, Illinois, licensed in Illinois (051.304276) and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1356066120
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameJACOB FREDERICKS
Location Address3100 S MACARTHUR BLVDSpringfield, IL 62704-5800
Mailing Address708 W Oak StGillespie, IL 62033-1240
Sole ProprietorYes
Enumeration DateOctober 5, 2022
NPPES CertifiedOctober 5, 2022
NPI 1356066120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in IL · 051.304276
Definition
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.
3100 S MACARTHUR BLVD, Springfield, IL 62704

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Fredericks's NPI number?

The NPI number for Jacob Fredericks is 1356066120. It was assigned to this individual provider in the NPPES registry on October 5, 2022.

Where is Jacob Fredericks located?

Jacob Fredericks practices at 3100 S Macarthur Blvd, Springfield, IL 62704. The listed phone number is (217) 528-4926.

What is Jacob Fredericks's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Jacob Fredericks was last updated on October 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.