Individual provider Active NPI

Isa Hamdan, PHARMD

  • Pharmacist
  • Homer Glen, IL
National Provider Identifier
1619249281
Registry record updated Jan 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.291876 Issued in IL
Practice address
13107 Sparrow CT
Homer Glen, IL 60491-8701
Phone
(708) 439-4916
NPI assigned
Jan 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.291876 IL Primary

Addresses

Primary practice location

13107 Sparrow CT
Homer Glen, IL 60491-8701

Mailing address

13107 Sparrow CT
Homer Glen, IL 60491-8701
Phone (708) 439-4916

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
051.291876ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1327795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327795200000",
    "number": "1619249281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13107 SPARROW CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918701",
            "telephone_number": "708-439-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13107 SPARROW CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918701",
            "telephone_number": "708-439-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMDAN",
        "first_name": "ISA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-29",
        "last_updated": "2012-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.291876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2012; 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.