Individual provider Active NPI

Jocelyn Visaysouk

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1821373770
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051290065 Issued in IL
Practice address
1520 W Fullerton Ave
Chicago, IL 60614-2023
Phone
(773) 929-6868
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 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 051290065 IL Primary

Addresses

Primary practice location

1520 W Fullerton Ave
Chicago, IL 60614-2023

Mailing address

1520 W Fullerton Ave
Chicago, IL 60614-2023
Phone (773) 929-6868

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

LicenseStateTypeSpecialty
051290065ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1821373770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142023",
            "telephone_number": "773-929-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142023",
            "telephone_number": "773-929-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISAYSOUK",
        "first_name": "JOCELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051290065",
            "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 Oct 11, 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.