Individual provider Active NPI

Raihan Shafi Pothigara, PHARMD

  • Pharmacist
  • Streamwood, IL
National Provider Identifier
1285299693
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
298091 Issued in IL
Practice address
128 Azalea Cir
Streamwood, IL 60107-1847
Phone
(224) 522-5734
NPI assigned
May 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 71844 CA
Pharmacist 183500000X 298091 IL Primary

Addresses

Primary practice location

128 Azalea Cir
Streamwood, IL 60107-1847

Mailing address

128 Azalea Cir
Streamwood, IL 60107-1847

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
71844CAMDPharmacist
298091ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1285299693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 AZALEA CIR",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 AZALEA CIR",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071847",
            "telephone_number": "224-522-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHIGARA",
        "first_name": "RAIHAN",
        "middle_name": "SHAFI",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "71844",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "298091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.