Basic Information
| Provider Information | |||||||||
| NPI: | 1992010813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMER | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E LEFEVRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610811279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156250400 | ||||||||
| FaxNumber: | 8156257031 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E LEFEVRE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610811279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156250400 | ||||||||
| FaxNumber: | 8156257031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2010 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 051.294209 | IL | Y | Pharmacy Service Providers | Pharmacist | 183500000X | 2010027518 | MO | N | Pharmacy Service Providers | Pharmacist |
No ID Information.