Individual provider Active NPI

Marc Yanow, R.PH.

  • Pharmacist
  • Rockford, IL
National Provider Identifier
1184904732
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-029697 Issued in IL
Practice address
3803 Auburn St
Rockford, IL 61101-2501
Phone
(815) 963-3705
Fax
(815) 963-1776
NPI assigned
Aug 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-029697 IL Primary

Addresses

Primary practice location

3803 Auburn St
Rockford, IL 61101-2501

Mailing address

3803 Auburn St
Rockford, IL 61101-2501

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
051-029697ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1184904732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 AUBURN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611012501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 AUBURN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611012501",
            "telephone_number": "815-963-3705",
            "fax_number": "815-963-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANOW",
        "first_name": "MARC",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-029697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.