Individual provider Active NPI

Jasmine Elisa Mudiyappan, PHARMD

  • Pharmacist
  • Mount Prospect, IL
National Provider Identifier
1093620692
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051307782 Issued in IL
Practice address
1814 W Pheasant TRL
Mount Prospect, IL 60056-4557
Phone
(847) 612-3540
NPI assigned
Aug 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051307782 IL Primary

Addresses

Primary practice location

1814 W Pheasant TRL
Mount Prospect, IL 60056-4557

Mailing address

1814 W Pheasant TRL
Mount Prospect, IL 60056-4557

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

NPI Registry JSON

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

{
    "created_epoch": "1787011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1093620692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 W PHEASANT TRL",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600564557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 W PHEASANT TRL",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600564557",
            "telephone_number": "847-612-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIYAPPAN",
        "first_name": "JASMINE",
        "middle_name": "ELISA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-18",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051307782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.