Active NPI
Lisa M Tang
- Pharmacist
- Berwyn, IL
National Provider Identifier
1063792646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051291370
- Practice address
- 6800 Ogden Ave
Berwyn, IL 60402-3643 - Phone
- (708) 749-9061
- Fax
- (708) 749-2478
- NPI assigned
- Aug 26, 2011
- Last updated
- Aug 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051291370 | IL | Primary |
Addresses
Primary practice location
6800 Ogden Ave
Berwyn, IL 60402-3643
Mailing address
1735 N Paulina St
#512
Chicago, IL 60622-1133
Phone (708) 749-9061
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051291370 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1063792646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1735 N PAULINA ST",
"address_2": "#512",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606221133",
"telephone_number": "708-749-9061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 OGDEN AVE",
"city": "BERWYN",
"state": "IL",
"postal_code": "604023643",
"telephone_number": "708-749-9061",
"fax_number": "708-749-2478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANG",
"first_name": "LISA",
"middle_name": "M",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051291370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.