Kimberly Marie Beranek, PHARMD. – Pharmacist

Key facts

NPI: 1144367756
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 051286728 (IL)
Practice address: 10204 Werch Dr Ste 302
Woodridge, IL 60517-5085
Phone: (877) 662-6633
NPI assigned: Jan 31, 2007
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Sina Drug LLC Specialty Pharmacy · Woodridge, IL · NPI 1053800052

NPD (past)
Sina Drug LLC Specialty Pharmacy · Scottsdale, AZ · NPI 1275245870

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
051286728	IL	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Sina Drug LLC		Past	Accepting new patients
Sina Drug LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	051286728	IL	Yes

Addresses

Primary practice location

10204 Werch Dr Ste 302
Woodridge, IL 60517-5085

Mailing address

10204 Werch Dr Ste 302
Woodridge, IL 60517-5085
Phone (877) 662-6633

Other names

Kimberly Marie Beranek Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 12, 2018.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1144367756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10204 WERCH DR STE 302",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175085",
            "telephone_number": "877-662-6633",
            "fax_number": "630-545-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10204 WERCH DR STE 302",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175085",
            "telephone_number": "877-662-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERANEK",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BERANEK",
            "middle_name": "MARIE",
            "credential": "PHARMD.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodridge, IL

All providers in Woodridge, IL · Pharmacist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2018. 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.

Verify at the official NPI Registry.