Manjiri Miriam Mathew, PHARM D, BCPS

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

051290870 Issued in IL

Practice address

3001 Green Bay Rd
North Chicago, IL 60064-3048

Phone

(224) 610-4652

Fax

(224) 610-3751

NPI assigned

Jan 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1457773269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 WINCHESTER LN",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600265748",
            "telephone_number": "847-721-4171",
            "fax_number": "866-367-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-4652",
            "fax_number": "224-610-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "MANJIRI",
        "middle_name": "MIRIAM",
        "name_prefix": "Mrs.",
        "credential": "PHARM D, BCPS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": "051290870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karona Monica Mason, DPM
• Lillian Matanmi, RN
• Bruce Liron Matchin, DOCTOR OF OSTEOPATHY
• Arun Mathew, PHARMD
• Joshua Dev Mathew, DDS, MPH
• Mintu Mathew, RN
• Anna Matyja
• Gregory Peter Mavromatis, MSW
• Emily McCarthy
• Erick Mitchell McCormick, RN

• Pharmacotherapy Pharmacist in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Pharmacotherapy Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.