MATTHEW RAYMOND ILLICH PHARMD
NPI 1558972307
Pharmacist in Gulfport, MS

Active since August 14, 2020
1417 E PASS RD, GULFPORT, MS 39507(228) 896-3870 Get Directions Write a Review

NPPES record last updated: December 26, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 26, 2022, Aug 14, 2020 (2 updates tracked since 2020).

About Matthew Raymond Illich Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW RAYMOND ILLICH PHARMD (NPI 1558972307) is an individual pharmacist in Gulfport, Mississippi, licensed in Mississippi (16174) and active in the NPI registry since August 2020. He maintains a secondary practice location in Ridgeland.

NPPES Registry Identity

NPI1558972307
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameMATTHEW RAYMOND ILLICHCredential: PHARMD
Location Address1417 E PASS RDGulfport, MS 39507-3522
Mailing Address905 Sea Cove StPascagoula, MS 39581-2166
Sole ProprietorNo
Enumeration DateAugust 14, 2020
Last NPPES UpdateDecember 26, 20222 updates tracked since enumeration
NPPES CertifiedDecember 26, 2022
NPI 1558972307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in MS · 16174
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
1417 E PASS RD, Gulfport, MS 39507

Secondary Practice Location 1

Location 16970 Old Canton RdRidgeland, MS 39157-1229 · Phone (601) 956-3844

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacy
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507
Pharmacist
1417 E PASS RD
GULFPORT, MS 39507

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Illich's NPI number?

The NPI number for Matthew Illich is 1558972307. It was assigned to this individual provider in the NPPES registry on August 14, 2020.

Where is Matthew Illich located?

Matthew Illich practices at 1417 E Pass Rd, Gulfport, MS 39507. The listed phone number is (228) 896-3870.

What is Matthew Illich's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Matthew Illich was last updated on December 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.