Active NPI
Paul Lyndon Thames Jr.
- Pharmacist
- Cicero, IL
National Provider Identifier
1154921724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051300182
- Practice address
- 3320 S Cicero Ave
Cicero, IL 60804-4531 - Phone
- (708) 652-8091
- NPI assigned
- Oct 31, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 051300182 | IL | Primary |
Addresses
Primary practice location
3320 S Cicero Ave
Cicero, IL 60804-4531
Mailing address
648 Gordon Ave
Calumet City, IL 60409-4110
Phone (773) 972-4268
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 |
|---|---|---|---|
| 051300182 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604102400000",
"number": "1154921724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "648 GORDON AVE",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604094110",
"telephone_number": "773-972-4268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 S CICERO AVE",
"city": "CICERO",
"state": "IL",
"postal_code": "608044531",
"telephone_number": "708-652-8091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAMES",
"first_name": "PAUL",
"middle_name": "LYNDON",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-31",
"last_updated": "2020-10-31",
"certification_date": "2020-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051300182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.