Individual provider Active NPI

Sam Jordan Alice Miller, PHARMD, RPH

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1598377103
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051304354 Issued in IL
Practice address
3501 N Halsted St
Chicago, IL 60657-1832
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
Aug 17, 2020
Last updated
Aug 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051304354 IL Primary

Addresses

Primary practice location

3501 N Halsted St
Chicago, IL 60657-1832

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (872) 269-3657

Other practice location 1

641 W 63rd St
Chicago, IL 60621-2032
Phone (773) 388-1600

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
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051304354ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1598377103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "872-269-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571832",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 W 63rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606212032",
            "country_code": "US",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SAM",
        "middle_name": "JORDAN ALICE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051304354",
            "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 Aug 29, 2025; 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.