Martha Lena Braun, PHARMD
Individual provider Active NPI Pharmacist · Mundelein, IL
NPI 1154044816 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1154044816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.304984 (IL)
- Practice address
- 3100 W Il Route 60
Mundelein, IL 60060-4267 - Phone
- (847) 367-2660
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 051.304984 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.304984 | IL | Yes |
Addresses
Primary practice location
3100 W Il Route 60
Mundelein, IL 60060-4267
Mailing address
660 W Huron Hills TRL # R
Round Lake Heights, IL 60073-1189
Phone (847) 431-6799
Other names
- Martha Lena Gibson
Other providers in Mundelein, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 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.