Individual provider Active NPI

Duann McIlvain, PHARM.D.

  • Pharmacist
  • Glendale, AZ
National Provider Identifier
1770911364
Registry record updated Oct 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12722 Issued in OK
Practice address
4720 W Palo Verde Ave
Glendale, AZ 85302-3633
Phone
(623) 748-3556
NPI assigned
Oct 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S016532 AZ
Pharmacist 183500000X 12722 OK Primary
Pharmacist 183500000X 39165 TX

Addresses

Primary practice location

4720 W Palo Verde Ave
Glendale, AZ 85302-3633

Mailing address

4720 W Palo Verde Ave
Glendale, AZ 85302-3633
Phone (623) 748-3556

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
S016532AZMDPharmacist
12722OKMDPharmacist
39165TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1770911364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 W PALO VERDE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023633",
            "telephone_number": "623-748-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 W PALO VERDE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853023633",
            "telephone_number": "623-748-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVAIN",
        "first_name": "DUANN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S016532",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "12722",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "39165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.