Active NPI
Kenneth Robert Krueger, RPH
- Pharmacist
- Kewanee, IL
National Provider Identifier
1134716731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051034094
- Practice address
- 500 S Main St
Kewanee, IL 61443-2818 - Phone
- (309) 853-4412
- Fax
- (309) 853-9810
- NPI assigned
- Dec 29, 2020
- Last updated
- Dec 29, 2020
- Sex
- Male
- 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 | 051034094 | IL | Primary |
Addresses
Primary practice location
500 S Main St
Kewanee, IL 61443-2818
Mailing address
325 W Locust St
Cambridge, IL 61238-1122
Phone (309) 937-2725
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051034094 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1134716731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 W LOCUST ST",
"city": "CAMBRIDGE",
"state": "IL",
"postal_code": "612381122",
"telephone_number": "309-937-2725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MAIN ST",
"city": "KEWANEE",
"state": "IL",
"postal_code": "614432818",
"telephone_number": "309-853-4412",
"fax_number": "309-853-9810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "KENNETH",
"middle_name": "ROBERT",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051034094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kewanee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.