Individual provider Active NPI

Hani F Abdallah, PHARMACIST

  • Pharmacist
  • Homer Glen, IL
National Provider Identifier
1851488787
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
05138672 Issued in IL
Practice address
16112 Syd Creek Dr
Homer Glen, IL 60491-5606
Phone
(708) 307-7839
NPI assigned
Oct 10, 2006
Last updated
Dec 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 05138672 IL Primary

Addresses

Primary practice location

16112 Syd Creek Dr
Homer Glen, IL 60491-5606

Mailing address

16112 Syd Creek Dr
Homer Glen, IL 60491-5606
Phone (708) 307-7839

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

State licenses

LicenseStateTypeSpecialty
05138672ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Pharmacy Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1851488787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16112 SYD CREEK DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604915606",
            "telephone_number": "708-307-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16112 SYD CREEK DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604915606",
            "telephone_number": "708-307-7839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "HANI",
        "middle_name": "F",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "05138672",
            "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 Dec 21, 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.

Verify at the official NPI Registry.