Provider Demographics
NPI:1992010813
Name:HAMMER, MATTHEW J (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:HAMMER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LEFEVRE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1279
Mailing Address - Country:US
Mailing Address - Phone:815-625-0400
Mailing Address - Fax:815-625-7031
Practice Address - Street 1:100 E LEFEVRE RD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-1279
Practice Address - Country:US
Practice Address - Phone:815-625-0400
Practice Address - Fax:815-625-7031
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294209183500000X
MO2010027518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist