Community Pharmacy of Chicago Ridge Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

54-016794 Issued in IL

Legal business name

COMMUNITY PHARMACY OF CHICAGO RIDGE INC

Doing business as

Community Pharmacy of Chicago Ridge

Practice address

9830 Ridgeland Ave
Chicago Ridge, IL 60415-2667

Phone

(708) 961-4980

Fax

(773) 890-1802

NPI assigned

Jan 21, 2010

Last updated

Nov 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jawad H Hamdan, PHARMDNPI 1043813694

Title

President/Pic

Phone

(708) 229-2100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Community Pharmacy of Chicago Ridge Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jawad H Hamdan, PHARMD

  • Pharmacist
  • Chicago, IL
  • NPI 1043813694

  Critical Care

  NPD Authorized official

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606003200000",
    "number": "1649501206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152667",
            "telephone_number": "708-229-2100",
            "fax_number": "708-229-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 RIDGELAND AVE",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152667",
            "telephone_number": "708-961-4980",
            "fax_number": "773-890-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PHARMACY OF CHICAGO RIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A",
        "authorized_official_last_name": "HAMDAN",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/PIC",
        "authorized_official_telephone_number": "708-229-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "054-016794",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "54-016794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT OF FINANCIAL AND PROFESSIONAL REGULATION - PHARMACY LICENSE",
            "identifier": "54-016794",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy of Chicago Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chicago Ridge Skilled Nursing Facility LLC (Avantara Chicago Ridge)
• Chicago Ridge SNF LLC
• Mary Ann Collins, MD
• Jerry Renato Coltro, M.D.
• Community Occupational Therapy
• Alayna Constance Corden, D.M.D.
• Core Anesthesia PLLC
• Brett Wayne Cox, M.D.
• Jenea Crawford
• Narmen Daik

• Pharmacy in Chicago Ridge, IL
• Providers in Chicago Ridge, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.