Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew Raymond Illich, PHARMD

Individual provider Pharmacist · NPI 1558972307

Matthew Raymond Illich, PHARMD is a Pharmacist in Gulfport, Mississippi. Works from 2 locations. Licensed in Mississippi.

Licensed in
MS
In the registry since
2020
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

1417 E Pass Rd
Gulfport, MS 39507-3522
Phone: (228) 896-3870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6970 Old Canton Rd, Ridgeland, MS 39157-1229 — (601) 956-3844

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 16174 (MS)

Record details

NPI number1558972307
Entity typeIndividual (Type 1)
GenderMale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedAugust 14, 2020
Last updated in NPPESDecember 26, 2022
Certification dateDecember 26, 2022

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