Active NPI
Moutaz Hemaidat
- Pharmacist
- Hickory Hills, IL
National Provider Identifier
1174213342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051292955
- Practice address
- 9443 S 81St CT
Hickory Hills, IL 60457-1907 - Phone
- (708) 543-5594
- NPI assigned
- May 11, 2023
- Last updated
- May 11, 2023
- 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 | 051292955 | IL | Primary |
Addresses
Primary practice location
9443 S 81St CT
Hickory Hills, IL 60457-1907
Mailing address
9443 S 81St CT
Hickory Hills, IL 60457-1907
Phone (708) 543-5594
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 |
|---|---|---|---|
| 051292955 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683763200000",
"number": "1174213342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9443 S 81ST CT",
"city": "HICKORY HILLS",
"state": "IL",
"postal_code": "604571907",
"telephone_number": "708-543-5594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9443 S 81ST CT",
"city": "HICKORY HILLS",
"state": "IL",
"postal_code": "604571907",
"telephone_number": "708-543-5594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEMAIDAT",
"first_name": "MOUTAZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-11",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051292955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hickory Hills, IL
- Chelsea Hands
- Hanan M Hasan, PHARMD
- Lorna Hays, CSADC
- Healthy Connection Hickory Hills Inc
- Daniel Joseph Healy, DDS
- Sarah Maria Henry, MS
- Hickory Dentistry LLC
- Hickory Medical Corporation, S.C. (Midwest Chiropractic Care Center)
- Hickory Nursing Pavilion
- Hickory Village Nursing and Rehabilitation Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.