Active NPI
Kelly Marie Procailo, PHARMD
- Pharmacist
- Livonia, MI
National Provider Identifier
1003118175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302035561
- Practice address
- 29965 McIntyre St
Livonia, MI 48150-3026 - Phone
- (734) 612-7752
- NPI assigned
- Nov 23, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 5302035561 | MI | Primary |
Addresses
Primary practice location
29965 McIntyre St
Livonia, MI 48150-3026
Mailing address
57679 Cider Mill Dr
New Hudson, MI 48165-9480
Phone (734) 612-7752
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 |
|---|---|---|---|
| 5302035561 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1003118175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57679 CIDER MILL DR",
"city": "NEW HUDSON",
"state": "MI",
"postal_code": "481659480",
"telephone_number": "734-612-7752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29965 MCINTYRE ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503026",
"telephone_number": "734-612-7752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCAILO",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-23",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302035561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
- Priority One Health Management
- Miranda Pritchard
- Private Notes 360 LLC
- Pro Therapy Center, PLLC (Grace Gates)
- Probity Therapy Care
- Prodigious Staffing
- Professional Breathing Associates Inc (Medwest Medical Supply)
- Professional Counseling and Psychiatry Solutions, PLLC
- Professional Dental Alliance of Michigan LLC
- Professional Dental Alliance of Michigan, LLC (Dental Care of Michigan, Livonia)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.