Individual provider Active NPI

Tarlika M Patel, RPH

  • Pharmacist
  • Pontiac, IL
National Provider Identifier
1891396354
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.293064 Issued in IL
Practice address
1706 W Reynolds St
Pontiac, IL 61764-9695
Phone
(815) 842-2230
NPI assigned
Nov 2, 2020
Last updated
Nov 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.293064 IL Primary

Addresses

Primary practice location

1706 W Reynolds St
Pontiac, IL 61764-9695

Mailing address

1634 Mockingbird LN
Pontiac, IL 61764-9248
Phone (701) 641-3365

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
051.293064ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1891396354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 MOCKINGBIRD LN",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649248",
            "telephone_number": "701-641-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649695",
            "telephone_number": "815-842-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TARLIKA",
        "middle_name": "M",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.293064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.