Individual provider Active NPI

Heba Kazoun

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1235541335
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051296764 Issued in IL
Practice address
2656 N Elston Ave
Chicago, IL 60647-2019
Phone
(773) 289-1012
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051296764 IL Primary

Addresses

Primary practice location

2656 N Elston Ave
Chicago, IL 60647-2019

Mailing address

100 E 14TH St
2508
Chicago, IL 60605-2889
Phone (708) 278-2088

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

LicenseStateTypeSpecialty
051296764ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1235541335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 14TH ST",
            "address_2": "2508",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052889",
            "telephone_number": "708-278-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2656 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472019",
            "telephone_number": "773-289-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZOUN",
        "first_name": "HEBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051296764",
            "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 May 22, 2014; 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.