Individual provider Active NPI

Alexandra Goncharenko, PHARM.D.

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1285092379
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.297668 Issued in IL
Practice address
833 S Wood St RM 164
University of Illinois at Chicago College of Pharmacy
Chicago, IL 60612-7229
Phone
(312) 996-1366
Fax
(312) 996-0379
NPI assigned
Feb 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.297668 IL Primary

Addresses

Primary practice location

833 S Wood St RM 164
University of Illinois at Chicago College of Pharmacy
Chicago, IL 60612-7229

Mailing address

833 S Wood St, RM 164 (MC 886)
University of Illinois at Chicago College of Pharmacy
Chicago, IL 60612
Phone (312) 996-1366

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
051.297668ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1285092379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST, RM 164 (MC 886)",
            "address_2": "UNIVERSITY OF ILLINOIS AT CHICAGO COLLEGE OF PHARMACY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-1366",
            "fax_number": "312-996-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST RM 164",
            "address_2": "UNIVERSITY OF ILLINOIS AT CHICAGO COLLEGE OF PHARMACY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127229",
            "telephone_number": "312-996-1366",
            "fax_number": "312-996-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHARENKO",
        "first_name": "ALEXANDRA",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.297668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.