Individual provider Active NPI

Bhumi Khambholja

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1043667512
Registry record updated May 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051292861 Issued in IL
Practice address
3572 N Elston Ave
Chicago, IL 60618-4318
Phone
(773) 583-9858
NPI assigned
May 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051292861 IL Primary

Addresses

Primary practice location

3572 N Elston Ave
Chicago, IL 60618-4318

Mailing address

3572 N Elston Ave
Chicago, IL 60618-4318

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

State licenses

LicenseStateTypeSpecialty
051292861ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
American Drug Stores LLC Past Accepting new patients
American Drug Stores LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463270400000",
    "number": "1043667512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3572 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3572 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184318",
            "telephone_number": "773-583-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMBHOLJA",
        "first_name": "BHUMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-15",
        "last_updated": "2016-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051292861",
            "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 May 15, 2016; 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.