Active NPI
Lauren Nicole Miklavcic, PHARMD
- Pharmacist
- East Peoria, IL
National Provider Identifier
1235743600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.295196
- Practice address
- 301 W Washington St
East Peoria, IL 61611-2036 - Phone
- (309) 427-2931
- NPI assigned
- Sep 3, 2020
- Sex
- Female
- 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 | 051.295196 | IL | Primary |
Addresses
Primary practice location
301 W Washington St
East Peoria, IL 61611-2036
Mailing address
348 E Eller Dr
East Peoria, IL 61611-5417
Phone (309) 202-6800
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 |
|---|---|---|---|
| 051.295196 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1235743600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "348 E ELLER DR",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616115417",
"telephone_number": "309-202-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W WASHINGTON ST",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616112036",
"telephone_number": "309-427-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKLAVCIC",
"first_name": "LAUREN",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-03",
"last_updated": "2020-09-03",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.295196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.