Individual provider Active NPI

Ilvana Radosevic, PHARMD

  • Pharmacist
  • Salem, MA
National Provider Identifier
1518567304
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH233338 Issued in MA
Practice address
450 Highland Ave
Salem, MA 01970-1765
Phone
(978) 825-0845
Fax
(978) 825-0898
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH233338 MA Primary

Addresses

Primary practice location

450 Highland Ave
Salem, MA 01970-1765

Mailing address

450 Highland Ave
Salem, MA 01970-1765
Phone (978) 825-0845

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
PH233338MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1518567304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701765",
            "telephone_number": "978-825-0845",
            "fax_number": "978-825-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701765",
            "telephone_number": "978-825-0845",
            "fax_number": "978-825-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOSEVIC",
        "first_name": "ILVANA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH233338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.

Verify at the official NPI Registry.