Active NPI
John Ilic
- Pharmacist
- River Forest, IL
National Provider Identifier
1669013579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-286228
- Practice address
- 542 Lathrop Ave
River Forest, IL 60305-1835 - Phone
- (630) 815-5064
- NPI assigned
- Oct 1, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-286228 | IL | Primary |
Addresses
Primary practice location
542 Lathrop Ave
River Forest, IL 60305-1835
Mailing address
542 Lathrop Ave
River Forest, IL 60305-1835
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051-286228 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569888000000",
"number": "1669013579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "542 LATHROP AVE",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "542 LATHROP AVE",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051835",
"telephone_number": "630-815-5064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILIC",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-01",
"last_updated": "2019-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-286228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.