Mary Kate Donovan
Individual provider Active NPI Pharmacist · Lemont, IL
NPI 1154031888 · NPPES record last updated Dec 5, 2022
Key facts
- NPI
- 1154031888
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.305230 (IL)
- Practice address
- 15575 E 127TH St
Lemont, IL 60439-4433 - Phone
- (630) 257-9250
- NPI assigned
- Dec 5, 2022
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.305230 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.305230 | IL | Yes |
Addresses
Primary practice location
15575 E 127TH St
Lemont, IL 60439-4433
Mailing address
0N057 Nepil Ave
Wheaton, IL 60187-3966
Other providers in Lemont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2022. 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.