{"npi":"1811902455","type":"NPI-2","status":"active","name":{"display":"Provena Pharmacy Elgin","other":[],"organization_name":"PROVENA PHARMACY ELGIN","authorised_official":"Satya Rao"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"3336C0002X","description":"Clinic Pharmacy","primary":false,"state":"IL","license":"54013758"},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"750 FLETCHER DR","city":"ELGIN","state":"IL","postal_code":"601234703","country_code":"US","street_2":"STE 103","phone":"8479315535","fax":"8496222072"},{"purpose":"MAILING","street_1":"750 FLETCHER DR","city":"ELGIN","state":"IL","postal_code":"601234703","country_code":"US","street_2":"STE 103"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"1460803","state":null,"issuer":"OTHER ID NUMBER-COMMERCIAL NUMBER"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-07-30","last_updated":"2025-09-11","_meta":{"source":"NPPES","snapshot_date":"2025-09-11","doc_url":"https://findmynpi.com/api"}}