Individual provider Active NPI

Paul Stephen Djuricich, PHARMD

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1831435866
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.289565 Issued in IL
Practice address
912 W Belmont Ave
Chicago, IL 60657-7679
Phone
(773) 665-8990
Fax
(773) 665-9766
NPI assigned
Dec 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.289565 IL Primary

Addresses

Primary practice location

912 W Belmont Ave
Chicago, IL 60657-7679

Mailing address

912 W Belmont Ave
Chicago, IL 60657-7679
Phone (773) 665-8990

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
051.289565ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1831435866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577679",
            "telephone_number": "773-665-8990",
            "fax_number": "773-665-9766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577679",
            "telephone_number": "773-665-8990",
            "fax_number": "773-665-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJURICICH",
        "first_name": "PAUL",
        "middle_name": "STEPHEN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-19",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.289565",
            "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 Dec 19, 2012; 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.