NPIMap

Individual provider Active NPI

Alexandra Suvajlo, BS

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1588944128
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-36996 Issued in IL
Practice address
3611 E 106TH St
Chicago, IL 60617-6610
Phone
(773) 978-1988
Fax
(773) 978-4325
NPI assigned
Aug 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-36996 IL Primary

Addresses

Primary practice location

3611 E 106TH St
Chicago, IL 60617-6610

Mailing address

3611 E 106TH St
Chicago, IL 60617-6610
Phone (773) 978-1988

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
051-36996ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1588944128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 E 106TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176610",
            "telephone_number": "773-978-1988",
            "fax_number": "773-978-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 E 106TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176610",
            "telephone_number": "773-978-1988",
            "fax_number": "773-978-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUVAJLO",
        "first_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-36996",
            "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 Aug 26, 2011; 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.