Individual provider Active NPI

Elizabeth Eleanor Reid-Tate, PHARMD

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1164790515
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-287978 Issued in IL
Practice address
5222 W. Madison Avenue
Chicago, IL 60644
Phone
(773) 287-0380
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-287978 IL Primary

Addresses

Primary practice location

5222 W. Madison Avenue
Chicago, IL 60644

Mailing address

1094 Crestwood Court
Bolingbrook, IL 60440
Phone (630) 679-9594

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
051-287978ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1164790515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 CRESTWOOD COURT",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "60440",
            "telephone_number": "630-679-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 W. MADISON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60644",
            "telephone_number": "773-287-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID-TATE",
        "first_name": "ELIZABETH",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-287978",
            "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 Dec 13, 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.

Verify at the official NPI Registry.