Active NPI
Brian Pavur
- Pharmacist
- Villa Park, IL
National Provider Identifier
1194520916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.041169
- Practice address
- 200 E Roosevelt Rd
Villa Park, IL 60181-3500 - Phone
- (630) 993-0869
- NPI assigned
- Feb 17, 2025
- 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 | 051.041169 | IL | Primary |
Addresses
Primary practice location
200 E Roosevelt Rd
Villa Park, IL 60181-3500
Mailing address
8324 163Rd St
Tinley Park, IL 60477-1225
Phone (925) 338-6008
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.041169 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739750400000",
"number": "1194520916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8324 163RD ST",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771225",
"telephone_number": "925-338-6008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E ROOSEVELT RD",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "601813500",
"telephone_number": "630-993-0869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVUR",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-17",
"last_updated": "2025-02-17",
"certification_date": "2025-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.041169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.