Individual provider Active NPI

Sandy Tiao, PHARMD

  • Pharmacist
  • Wilmette, IL
National Provider Identifier
1609158302
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051291186 Issued in IL
Practice address
811 Greenbay Rd
Wilmette, IL 60091
Phone
(847) 256-0881
NPI assigned
Sep 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051291186 IL Primary

Addresses

Primary practice location

811 Greenbay Rd
Wilmette, IL 60091

Mailing address

811 Greenbay Rd
Wilmette, IL 60091
Phone (847) 256-0881

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

State licenses

LicenseStateTypeSpecialty
051291186ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1609158302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 GREENBAY RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "60091",
            "telephone_number": "847-256-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 GREENBAY RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "60091",
            "telephone_number": "847-256-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAO",
        "first_name": "SANDY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-19",
        "last_updated": "2022-07-25",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051291186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.