Active NPI
Matthew Clinton Heishman, RPH
- Pharmacist
- Evanston, IL
National Provider Identifier
1659971893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.297315
- Practice address
- 2450 Main St
Evanston, IL 60202-1548 - Phone
- (847) 425-9428
- Fax
- (847) 425-9431
- NPI assigned
- Oct 27, 2020
- Sex
- Male
- 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 | 051.297315 | IL | Primary |
Addresses
Primary practice location
2450 Main St
Evanston, IL 60202-1548
Mailing address
910 W Margate Ter Unit 1W
Chicago, IL 60640-3810
Phone (847) 425-9428
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.297315 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1659971893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 W MARGATE TER UNIT 1W",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606403810",
"telephone_number": "847-425-9428",
"fax_number": "847-425-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 MAIN ST",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602021548",
"telephone_number": "847-425-9428",
"fax_number": "847-425-9431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEISHMAN",
"first_name": "MATTHEW",
"middle_name": "CLINTON",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.297315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.