Active NPI
Jordan Anderson Ambrose, PHARMD
- Pharmacist
- Chicago, IL
National Provider Identifier
1982951760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.295278
- Practice address
- 820 S Damen Ave
Chicago, IL 60612-3728 - Phone
- (312) 569-7841
- NPI assigned
- Aug 10, 2012
- Last updated
- Aug 10, 2012
- 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 | 051.295278 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
Chicago, IL 60612-3728
Mailing address
260 E Chestnut St Apt 1507
Chicago, IL 60611-2411
Phone (630) 988-9838
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 |
|---|---|---|---|
| 051.295278 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344556800000",
"number": "1982951760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 E CHESTNUT ST APT 1507",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112411",
"telephone_number": "630-988-9838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-7841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROSE",
"first_name": "JORDAN",
"middle_name": "ANDERSON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-10",
"last_updated": "2012-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.295278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.