Active NPI
Thao Pham, PHARM.D
- Pharmacist
- Orland Park, IL
National Provider Identifier
1679958417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.296467
- Practice address
- 14400 John Humphrey Dr
Suite 110
Orland Park, IL 60462-2897 - Phone
- (708) 460-4930
- Fax
- (708) 460-4932
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 051.296467 | IL | Primary |
Addresses
Primary practice location
14400 John Humphrey Dr
Suite 110
Orland Park, IL 60462-2897
Mailing address
14400 John Humphrey Dr
Suite 110
Orland Park, IL 60462-2897
Phone (708) 460-4930
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 |
|---|---|---|---|
| 051.296467 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convex Pharmacy, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Compounding Pharmacy
- Orland Park, IL
- NPI 1679918403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437523200000",
"number": "1679958417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14400 JOHN HUMPHREY DR",
"address_2": "SUITE 110",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604622897",
"telephone_number": "708-460-4930",
"fax_number": "708-460-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14400 JOHN HUMPHREY DR",
"address_2": "SUITE 110",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604622897",
"telephone_number": "708-460-4930",
"fax_number": "708-460-4932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "THAO",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-22",
"last_updated": "2015-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.296467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.