Active NPI
Tammy T McClellan, PHARMD
- Pharmacist
- Bourbonnais, IL
National Provider Identifier
1649826660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051289731
- Practice address
- 200 Riverside Dr
Bourbonnais, IL 60914-4689 - Phone
- (815) 935-7256
- NPI assigned
- Aug 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051289731 | IL | Primary |
Addresses
Primary practice location
200 Riverside Dr
Bourbonnais, IL 60914-4689
Mailing address
PO Box 483
Matteson, IL 60443-0483
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051289731 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1649826660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 483",
"city": "MATTESON",
"state": "IL",
"postal_code": "604430483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 RIVERSIDE DR",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609144689",
"telephone_number": "815-935-7256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAN",
"first_name": "TAMMY",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-15",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051289731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.