Individual provider Active NPI

Jerry Tuazon, PHARMD, BCPS

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1033467469
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051295954 Issued in IL
Practice address
2210 W 95TH St
Chicago, IL 60643-1002
Phone
(773) 341-3500
Fax
(773) 341-3501
NPI assigned
Aug 15, 2012
Last updated
Jan 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051295954 IL Primary

Addresses

Primary practice location

2210 W 95TH St
Chicago, IL 60643-1002

Mailing address

2210 W 95TH St
Chicago, IL 60643-1002
Phone (773) 341-3500

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051295954ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1033467469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431002",
            "telephone_number": "773-341-3500",
            "fax_number": "773-341-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431002",
            "telephone_number": "773-341-3500",
            "fax_number": "773-341-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUAZON",
        "first_name": "JERRY",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.