Simon A. Tar

Primary specialty

PharmacistTaxonomy code 183500000X

License

051288005 Issued in IL

Practice address

3950 W Devon Ave
Lincolnwood, IL 60712-1043

Phone

(847) 763-0685

Fax

(847) 763-0878

NPI assigned

Dec 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Highland Park CVS LLC

  • Pharmacy
  • Lincolnwood, IL
  • NPI 1215978135
  NPD (past)

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1497350086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 W DEVON AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121043",
            "telephone_number": "847-763-0685",
            "fax_number": "847-763-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 W DEVON AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121043",
            "telephone_number": "847-763-0685",
            "fax_number": "847-763-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAR",
        "first_name": "SIMON",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lincolnwood",
            "affiliation": "Y",
            "endpointDescription": "cvs pharmacy",
            "affiliationName": "HIGHLAND PARK CVS LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cvs pharmacy",
            "address_1": "3950 W Devon Ave",
            "city": "Lincolnwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607121043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.