Active NPI
Khalid Elamin
- Pharmacist
- Waukegan, IL
National Provider Identifier
1356008411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051304474
- Practice address
- 2200 N Lewis Ave
Waukegan, IL 60087-3885 - Phone
- (847) 623-6375
- Fax
- (847) 623-1554
- NPI assigned
- Nov 23, 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 | 051304474 | IL | Primary |
Addresses
Primary practice location
2200 N Lewis Ave
Waukegan, IL 60087-3885
Mailing address
5363 Oakton St
Skokie, IL 60077-2435
Phone (773) 317-8700
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 |
|---|---|---|---|
| 051304474 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Waukegan, IL
- NPI 1366457400
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1356008411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5363 OAKTON ST",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600772435",
"telephone_number": "773-317-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 N LEWIS AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600873885",
"telephone_number": "847-623-6375",
"fax_number": "847-623-1554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELAMIN",
"first_name": "KHALID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-23",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051304474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.