Kelly Anderson, PHARM.D,CCP

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI03147600 Issued in NJ

Practice address

5525 S Pulaski Rd
Chicago, IL 60629-4400

Phone

(773) 432-0100

Fax

(773) 432-0101

NPI assigned

Dec 8, 2010

Last updated

Jun 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1134422413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294400",
            "telephone_number": "773-432-0100",
            "fax_number": "773-432-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294400",
            "telephone_number": "773-432-0100",
            "fax_number": "773-432-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLY",
        "credential": "PHARM.D,CCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03147600",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "054233",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Anderson, LCSW
• Karla V Anderson, PSY.D.
• Katherine Anderson, APN
• Kayley Anderson, MSW
• Kelley Marie Anderson, APN
• Kim Anderson, FNP-BC
• Kristen E Anderson, LCPC
• Kristen Elizabeth Anderson, MA, LCSW
• Kristen Marie Anderson
• Kristina L Anderson, CSSW

• Pharmacist in Chicago, IL
• Providers in Chicago, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.