Individual provider Active NPI

Khadije M Chaalan, PHARMACIST

  • Pharmacist
  • Dearborn, MI
National Provider Identifier
1417439043
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032632 Issued in MI
Practice address
301 Golfcrest Dr
Dearborn, MI 48124-1172
Phone
(313) 903-5425
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032632 MI Primary

Addresses

Primary practice location

301 Golfcrest Dr
Dearborn, MI 48124-1172

Mailing address

301 Golfcrest Dr
Dearborn, MI 48124-1172
Phone (313) 903-5425

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

LicenseStateTypeSpecialty
5302032632MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1417439043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GOLFCREST DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241172",
            "telephone_number": "313-903-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GOLFCREST DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241172",
            "telephone_number": "313-903-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAALAN",
        "first_name": "KHADIJE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.