Individual provider Active NPI

Pamala J Pontikes, PHARMD

  • Pharmacotherapy Pharmacist
  • Chicago, IL
National Provider Identifier
1124226543
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
0051-038426 Issued in IL
Practice address
1901 W Harrison St
Department of Pharmacy
Chicago, IL 60612-3714
Phone
(312) 864-1239
Fax
(312) 864-9222
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 0051-038426 IL Primary

Addresses

Primary practice location

1901 W Harrison St
Department of Pharmacy
Chicago, IL 60612-3714

Mailing address

1960 Burton LN
Park Ridge, IL 60068-1572
Phone (847) 692-1908

Other names 1

  • Ms. Pamala J Tzallas Other name

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
0051-038426ILMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124226543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 BURTON LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681572",
            "telephone_number": "847-692-1908",
            "fax_number": "847-692-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-1239",
            "fax_number": "312-864-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIKES",
        "first_name": "PAMALA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": "0051-038426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMALA",
            "last_name": "TZALLAS",
            "middle_name": "J",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 8, 2007; 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.