Individual provider Active NPI

Olga Vyboitchenko, RPH

  • Pharmacist
  • Naperville, IL
National Provider Identifier
1215218417
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051288851 Issued in IL
Practice address
2648 Haddassah Dr
Naperville, IL 60565-3068
Phone
(630) 300-3875
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 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 051288851 IL Primary

Addresses

Primary practice location

2648 Haddassah Dr
Naperville, IL 60565-3068

Mailing address

2648 Haddassah Dr
Naperville, IL 60565-3068
Phone (630) 300-3875

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
051288851ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1215218417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 HADDASSAH DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605653068",
            "telephone_number": "630-300-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 HADDASSAH DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605653068",
            "telephone_number": "630-300-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYBOITCHENKO",
        "first_name": "OLGA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.