Individual provider Active NPI

Dennis Michael Moresco, R.P.H.

  • Pharmacist
  • Rockford, IL
National Provider Identifier
1790017036
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051035153 Issued in IL
Practice address
5909 E State St
Rockford, IL 61108-2429
Phone
(815) 229-5719
Fax
(815) 229-0013
NPI assigned
Feb 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051035153 IL Primary

Addresses

Primary practice location

5909 E State St
Rockford, IL 61108-2429

Mailing address

327 Eagle PT
Machesney Park, IL 61115-8356
Phone (815) 877-0368

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
051035153ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1790017036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 EAGLE PT",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611158356",
            "telephone_number": "815-877-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082429",
            "telephone_number": "815-229-5719",
            "fax_number": "815-229-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORESCO",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "R.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051035153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.