Active NPI
Everardo Jesus Mojica, PHARMD
- Pharmacy Technician
- Chicago, IL
National Provider Identifier
1013390202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 049.201057
- Practice address
- 6525 W Diversey Ave
Chicago, IL 60707-2312 - Phone
- (773) 804-3611
- NPI assigned
- Jul 7, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 049.201057 | IL | Primary |
Addresses
Primary practice location
6525 W Diversey Ave
Chicago, IL 60707-2312
Mailing address
3722 W Giddings St
Chicago, IL 60625-5739
Phone (773) 715-0919
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049.201057 | IL | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1013390202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3722 W GIDDINGS ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606255739",
"telephone_number": "773-715-0919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6525 W DIVERSEY AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "607072312",
"telephone_number": "773-804-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOJICA",
"first_name": "EVERARDO",
"middle_name": "JESUS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IL",
"license": "049.201057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.