Individual provider Active NPI

John Hagan

  • Pharmacist
  • Elmhurst, IL
National Provider Identifier
1508371220
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051032267 Issued in IL
Practice address
380 S Fairview Ave
Elmhurst, IL 60126-3711
Phone
(630) 530-8216
NPI assigned
Dec 4, 2017
Last updated
Dec 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051032267 IL Primary

Addresses

Primary practice location

380 S Fairview Ave
Elmhurst, IL 60126-3711

Mailing address

380 S Fairview Ave
Elmhurst, IL 60126-3711
Phone (630) 530-8216

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

LicenseStateTypeSpecialty
051032267ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1508371220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 S FAIRVIEW AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263711",
            "telephone_number": "630-530-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 S FAIRVIEW AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263711",
            "telephone_number": "630-530-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051032267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.