Active NPI
Mary Hieu Pham
- Pharmacist
- Deerfield, IL
National Provider Identifier
1255724209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72366
- Practice address
- 200 Wilmot Rd
Deerfield, IL 60015-4620 - Phone
- (847) 315-2500
- NPI assigned
- Mar 16, 2015
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 72366 | CA | Primary |
Addresses
Primary practice location
200 Wilmot Rd
Deerfield, IL 60015-4620
Mailing address
PO Box 6113
Moreno Valley, CA 92554-6113
Phone (951) 722-1347
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 |
|---|---|---|---|
| 72366 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426464000000",
"number": "1255724209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6113",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925546113",
"telephone_number": "951-722-1347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WILMOT RD",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600154620",
"telephone_number": "847-315-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "MARY HIEU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-16",
"last_updated": "2015-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.