Individual provider Active NPI

Michael W Baloun, R.PH.

  • Pharmacist
  • Bloomingdale, IL
National Provider Identifier
1649565268
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-037426 Issued in IL
Practice address
130 S Gary Ave
Bloomingdale, IL 60108-2243
Phone
(630) 351-7610
NPI assigned
Jun 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-037426 IL Primary

Addresses

Primary practice location

130 S Gary Ave
Bloomingdale, IL 60108-2243

Mailing address

130 S Gary Ave
Bloomingdale, IL 60108-2243
Phone (630) 351-7610

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051-037426ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1649565268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S GARY AVE",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082243",
            "telephone_number": "630-351-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S GARY AVE",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082243",
            "telephone_number": "630-351-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOUN",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-037426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.