Individual provider Active NPI

Jay L Hammerman, RPH

  • Pharmacy
  • Chicago, IL
National Provider Identifier
1407934482
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Sep 20, 2012.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Practice address
1104 W Thorndale Ave
Chicago, IL 60660-3516
Phone
(773) 561-6660
Fax
(773) 561-6685
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X IL Primary

Addresses

Primary practice location

1104 W Thorndale Ave
Chicago, IL 60660-3516

Mailing address

1104 W Thorndale Ave
Chicago, IL 60660-3516
Phone (773) 561-6660

Other identifiers 1

IdentifierTypeStateIssuer
363704718001MedicaidIL

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
054009897ILMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Thorndale Pharmacy Inc Pharmacy Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407934482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W THORNDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603516",
            "telephone_number": "773-561-6660",
            "fax_number": "773-561-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W THORNDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603516",
            "telephone_number": "773-561-6660",
            "fax_number": "773-561-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMERMAN",
        "first_name": "JAY",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363704718001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.