Individual provider Active NPI

Goran Miljevic, PHARMD

  • Pharmacist
  • Rockford, IL
National Provider Identifier
1275810707
Registry record updated Nov 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051291295 Issued in IL
Practice address
7151 Walton St
Rockford, IL 61108-2600
Phone
(815) 397-4291
Fax
(815) 397-4842
NPI assigned
Nov 11, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051291295 IL Primary

Addresses

Primary practice location

7151 Walton St
Rockford, IL 61108-2600

Mailing address

7151 Walton St
Rockford, IL 61108-2600
Phone (815) 397-4291

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

LicenseStateTypeSpecialty
051291295ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447545600000",
    "number": "1275810707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 WALTON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082600",
            "telephone_number": "815-397-4291",
            "fax_number": "815-397-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 WALTON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082600",
            "telephone_number": "815-397-4291",
            "fax_number": "815-397-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILJEVIC",
        "first_name": "GORAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-11",
        "last_updated": "2015-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051291295",
            "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 Nov 15, 2015; 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.