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Deactivated NPI 1497038145 Deactivated / Inactive NPI Male Practitioner

Mark Thomas Doherty , RPH

Pharmacist • Streator, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mark Doherty has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 20, 2011
NPI Deactivation Date January 17, 2022
Total Practice Duration ~11 Years of Practice (2011 – 2022)

Professional Overview & Biography Verified Profile Summary

Mark Doherty, RPH was a registered Pharmacist practicing in Streator, IL. Throughout an active medical career spanning 11 years, Mark Doherty provided care at the practice location at 120 E MAIN ST until profile deactivation on 2022-01-17.

Practice Location & Contact Primary Location

Practice Address

120 E Main St

Streator, IL 613642901

Telephone 8156732439
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1881609030

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Streator, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
13 Specialists

Practicing in Streator, IL (9983 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License IL 051030452

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1124308796

Registered Pharmacist

Meghan Hatzer

Pharmacist

NPI 1972970291

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 17, 2022

Record deactivated on January 17, 2022

NPI Profile Active September 20, 2011

NPI status registered as active in NPPES database

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Updated Practice Location September 20, 2011

Registered at 120 E MAIN ST, STREATOR, IL 613642901 (Tel: 8156732439)

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Updated Business Mailing Address September 20, 2011

Registered at 1210 W MADISON ST, OTTAWA, IL 613502567 (Tel: 8154332055)

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Provider Name / Credentials Updated September 20, 2011

Recorded as MARK DOHERTY, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2011

Pharmacist (License #051030452 in IL)

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Initial NPI Registration & Enumeration September 20, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497038145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2011
Last Update: September 20, 2011
Deactivation Date: January 17, 2022

Mailing Address

1210 W Madison St

Ottawa, IL 613502567

Phone: 8154332055

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.