Active NPI
Pamela W Hazard, M.D.
- Psychiatry Physician
- Evanston, IL
National Provider Identifier
1245536192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036082272
- Practice address
- 633 Emerson St
Evanston, IL 60208-4000 - Phone
- (847) 491-2151
- Fax
- (847) 467-1193
- NPI assigned
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036082272 | IL | Primary |
Addresses
Primary practice location
633 Emerson St
Evanston, IL 60208-4000
Mailing address
633 Emerson St
Evanston, IL 60208-4000
Phone (847) 491-2151
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036082272 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1245536192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 EMERSON ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602084000",
"telephone_number": "847-491-2151",
"fax_number": "847-467-1193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "633 EMERSON ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602084000",
"telephone_number": "847-491-2151",
"fax_number": "847-467-1193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZARD",
"first_name": "PAMELA",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036082272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
- David Lang Hauser, PH.D.
- Suzanne Nicole Hawley, LCSW
- Ilda Haxhistasa, PHARMD
- Heidi Johnston Hayden, LCPC
- Robert Lawrence Hayden, PHD
- Christine Hazelett, LCPC ATR-BC
- Health Solutions Comprehensive Quality Care LLC
- Takijah T. Heard, MD
- Heart of Transformation Wellness Institute SC
- Heather Yoon DDS, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.