Individual provider Active NPI

Simret Melese Gebremedhin

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1437914272
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051306124 Issued in IL
Practice address
3644 S Archer Ave
Chicago, IL 60609-1044
Phone
(773) 523-6923
NPI assigned
Feb 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051306124 IL Primary

Addresses

Primary practice location

3644 S Archer Ave
Chicago, IL 60609-1044

Mailing address

454 W 26TH St Apt BR
Chicago, IL 60616-5220
Phone (773) 678-8552

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
051306124ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1437914272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 W 26TH ST APT BR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606165220",
            "telephone_number": "773-678-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091044",
            "telephone_number": "773-523-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREMEDHIN",
        "first_name": "SIMRET",
        "middle_name": "MELESE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051306124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.