Individual provider Active NPI

Mark Rauman, R.PH.

  • Pharmacist
  • Bolingbrook, IL
National Provider Identifier
1013201276
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.033683 Issued in IL
Practice address
1188 W Boughton Rd
Target Pharmacy T-0867
Bolingbrook, IL 60440-1508
Phone
(630) 378-1011
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.033683 IL Primary
Pharmacist 183500000X 116292 MN
Pharmacist 183500000X 2001031809 MO

Addresses

Primary practice location

1188 W Boughton Rd
Target Pharmacy T-0867
Bolingbrook, IL 60440-1508

Mailing address

1188 W Boughton Rd
Target Pharmacy T-0867
Bolingbrook, IL 60440-1508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051.033683ILMDPharmacist
116292MNMDPharmacist
2001031809MOMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1013201276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 W BOUGHTON RD",
            "address_2": "TARGET PHARMACY T-0867",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 W BOUGHTON RD",
            "address_2": "TARGET PHARMACY T-0867",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401508",
            "telephone_number": "630-378-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUMAN",
        "first_name": "MARK",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.033683",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "116292",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2001031809",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.