Active NPI
Philip Y Song, PHARMD
- Pharmacist
- Evanston, IL
National Provider Identifier
1366566341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-287300
- Practice address
- 2748 Green Bay Rd
Evanston, IL 60201-1481 - Phone
- (847) 864-9370
- NPI assigned
- Mar 16, 2007
- 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 | 051-287300 | IL | Primary |
Addresses
Primary practice location
2748 Green Bay Rd
Evanston, IL 60201-1481
Mailing address
6815 N Milwaukee Ave Apt 706
Niles, IL 60714-4576
Phone (847) 668-4330
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 |
|---|---|---|---|
| 051-287300 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366566341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6815 N MILWAUKEE AVE APT 706",
"city": "NILES",
"state": "IL",
"postal_code": "607144576",
"telephone_number": "847-668-4330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2748 GREEN BAY RD",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011481",
"telephone_number": "847-864-9370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "PHILIP",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-287300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.