Individual provider Active NPI

Jalal Mataria, RPH

  • Pharmacist
  • Oak Lawn, IL
National Provider Identifier
1245820877
Registry record updated Oct 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051295156 Issued in IL
Practice address
6700 W 95TH St Ste 150
Oak Lawn, IL 60453-2280
Phone
(708) 598-5000
Fax
(708) 598-6737
NPI assigned
Jan 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051295156 IL Primary

Addresses

Primary practice location

6700 W 95TH St Ste 150
Oak Lawn, IL 60453-2280

Mailing address

222 Stone CT Ste C
New Lenox, IL 60451-1598
Phone (815) 666-1113

Other practice location 1

9603 S Pulaski Rd
Evergreen Park, IL 60805-2922
Phone (708) 272-1212

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051295156ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tablets Pharmacy Inc. CurrentSince Jan 24, 2021 Accepting new patients
Tablets Pharmacy Inc. CurrentSince Jan 24, 2021 Accepting new patients
S and R Drugs Inc / Dba: Sears Pharmacy Pharmacist Current Accepting new patients

Locations

9603 S Pulaski Rd
Evergreen Park, IL 60805
Phone (708) 272-1212

222 Stone Ct
Ste C
New Lenox, IL 60451

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696723200000",
    "number": "1245820877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STONE CT STE C",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511598",
            "telephone_number": "815-666-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 W 95TH ST STE 150",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532280",
            "telephone_number": "708-598-5000",
            "fax_number": "708-598-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9603 S Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052922",
            "country_code": "US",
            "telephone_number": "708-272-1212",
            "fax_number": "708-272-1222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATARIA",
        "first_name": "JALAL",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-18",
        "last_updated": "2023-10-08",
        "certification_date": "2023-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.

Verify at the official NPI Registry.