Sam B An, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

051297279 Issued in IL

Practice address

311 N Western Ave
Peoria, IL 61604-5638

Phone

(309) 676-6333

Fax

(309) 676-1928

NPI assigned

Sep 22, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Pharmacy of Il Inc

  • Long Term Care Pharmacy
  • Peoria, IL
  • NPI 1962239186
  NPD
• American Pharmacy of Il Inc

  • Pharmacy
  • West Peoria, IL
  • NPI 1871546432
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Peoria, IL
  • NPI 1023025053
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1003218090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N WESTERN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616045638",
            "telephone_number": "309-676-6333",
            "fax_number": "309-676-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N WESTERN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616045638",
            "telephone_number": "309-676-6333",
            "fax_number": "309-676-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AN",
        "first_name": "SAM",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051297279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy A Amos-Schulte, LICENSED CLINICAL SO
• Justin Amos, DO
• Amy Forsberg, LCPC, LLC
• An Honorable Living
• An Honorable Living
• Yezen Raed Anabtawi
• Chinenye Chioma Anako, M.D.,
• Lizda Linett Anaya Dahud, M.D.
• Freedom Rocillo Andal, AGACNP
• Whitney Renee Andal, APN

• Pharmacist in Peoria, IL
• Providers in Peoria, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.