Individual provider Active NPI

Samir Vinubhai Mashruwala

  • Pharmacist
  • Des Plaines, IL
National Provider Identifier
1942583570
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051286876 Issued in IL
Practice address
9033 Hollyberry Ave
Des Plaines, IL 60016-4216
Phone
(847) 321-9409
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051286876 IL Primary

Addresses

Primary practice location

9033 Hollyberry Ave
Des Plaines, IL 60016-4216

Mailing address

9033 Hollyberry Ave
Des Plaines, IL 60016-4216
Phone (847) 321-9409

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
051286876ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1942583570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 HOLLYBERRY AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164216",
            "telephone_number": "847-321-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 HOLLYBERRY AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164216",
            "telephone_number": "847-321-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHRUWALA",
        "first_name": "SAMIR",
        "middle_name": "VINUBHAI",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.