Active NPI
Yazan Samer Salah
- Pharmacist
- Midlothian, IL
National Provider Identifier
1306420187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051303868
- Practice address
- 4800 148TH St
Midlothian, IL 60445 - Phone
- (708) 687-1604
- NPI assigned
- May 8, 2021
- Sex
- Male
- 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 | 051303868 | IL | Primary |
Addresses
Primary practice location
4800 148TH St
Midlothian, IL 60445
Mailing address
15609 Rob Roy Dr.
Oak Forest, IL 60452
Phone (708) 829-6699
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 |
|---|---|---|---|
| 051303868 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620432000000",
"number": "1306420187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15609 ROB ROY DR.",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "60452",
"telephone_number": "708-829-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 148TH ST",
"city": "MIDLOTHIAN",
"state": "IL",
"postal_code": "60445",
"telephone_number": "708-687-1604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAH",
"first_name": "YAZAN",
"middle_name": "SAMER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-08",
"last_updated": "2021-05-08",
"certification_date": "2021-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051303868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.