Active NPI
Stanislav Gordon
- Pharmacy Technician
- Palatine, IL
National Provider Identifier
1871787994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- Practice address
- 503 E Fawn LN Unit C
Palatine, IL 60074-3937 - Phone
- (847) 528-0161
- NPI assigned
- Aug 31, 2007
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | IL | Primary |
Addresses
Primary practice location
503 E Fawn LN Unit C
Palatine, IL 60074-3937
Mailing address
503 E Fawn LN Unit C
Palatine, IL 60074-3937
Phone (847) 528-0161
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 |
|---|---|---|---|
| 049-125554 | IL | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188518400000",
"number": "1871787994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 E FAWN LN UNIT C",
"city": "PALATINE",
"state": "IL",
"postal_code": "600743937",
"telephone_number": "847-528-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 E FAWN LN UNIT C",
"city": "PALATINE",
"state": "IL",
"postal_code": "600743937",
"telephone_number": "847-528-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "STANISLAV",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-31",
"last_updated": "2007-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatine, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.