Active NPI
Momcilo Ryan, PHARMD.
- Pharmacist
- Cicero, IL
National Provider Identifier
1124544606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.300557
- Practice address
- 2901 S Cicero Ave
Cicero, IL 60804-3637 - Phone
- (708) 863-6833
- NPI assigned
- Aug 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.300557 | IL | Primary |
Addresses
Primary practice location
2901 S Cicero Ave
Cicero, IL 60804-3637
Mailing address
3150 Harlem Ave Apt 3I
Riverside, IL 60546-2090
Phone (630) 452-9920
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 |
|---|---|---|---|
| 051.300557 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502841600000",
"number": "1124544606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 HARLEM AVE APT 3I",
"city": "RIVERSIDE",
"state": "IL",
"postal_code": "605462090",
"telephone_number": "630-452-9920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 S CICERO AVE",
"city": "CICERO",
"state": "IL",
"postal_code": "608043637",
"telephone_number": "708-863-6833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "MOMCILO",
"name_prefix": "Dr.",
"credential": "PHARMD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-16",
"last_updated": "2017-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.300557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.