M Kathleen Dyke, RPH
Individual provider Active NPI Pharmacist · Rock Falls, IL
NPI 1104477421 · NPPES record last updated Sep 27, 2019
Key facts
- NPI
- 1104477421
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.036943 (IL)
- Practice address
- 1901 1St Ave
Rock Falls, IL 61071-3504 - Phone
- (815) 626-6803
- Fax
- (815) 626-6818
- NPI assigned
- Sep 27, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.036943 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past |
Accepting new patients | |
| Walmart Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.036943 | IL | Yes |
Addresses
Primary practice location
1901 1St Ave
Rock Falls, IL 61071-3504
Mailing address
1901 1St Ave
Rock Falls, IL 61071-3504
Phone (815) 626-6803
Other names
- M Kathy Dyke
Other providers in Rock Falls, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.