Active NPI
Nicholas Van Hise, PHARMD
- Infectious Diseases Pharmacist
- Burr Ridge, IL
National Provider Identifier
1346937646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Diseases Pharmacist
- License
- 051299140
- Practice address
- 901 McClintock Dr Ste 300
Burr Ridge, IL 60527-0872 - Phone
- (630) 655-6952
- Fax
- (630) 528-9550
- NPI assigned
- Apr 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Diseases Pharmacist | 1835I0206X | 2013027400 | MO | |
| Infectious Diseases Pharmacist | 1835I0206X | 051299140 | IL | Primary |
Addresses
Primary practice location
901 McClintock Dr Ste 300
Burr Ridge, IL 60527-0872
Mailing address
901 McClintock Dr Ste 300
Burr Ridge, IL 60527-0872
Phone (630) 655-6952
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051299140 | IL | MD | Medical license number |
| 2013027400 | MO | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1346937646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 MCCLINTOCK DR STE 300",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605270872",
"telephone_number": "630-655-6952",
"fax_number": "630-528-9550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MCCLINTOCK DR STE 300",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605270872",
"telephone_number": "630-655-6952",
"fax_number": "630-528-9550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN HISE",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "1835I0206X",
"taxonomy_group": "",
"desc": "Pharmacist, Infectious Diseases",
"state": "MO",
"license": "2013027400",
"primary": false
},
{
"code": "1835I0206X",
"taxonomy_group": "",
"desc": "Pharmacist, Infectious Diseases",
"state": "IL",
"license": "051299140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.