Kristen N Kubicz, PHARM.D.
Individual provider Active NPI Pharmacist · Midlothian, IL
NPI 1164705877 · NPPES record last updated Sep 20, 2011
Key facts
- NPI
- 1164705877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051291340 (IL)
- Practice address
- 14701 Pulaski Rd
Midlothian, IL 60445-3410 - Phone
- (708) 239-2150
- NPI assigned
- Sep 20, 2011
- 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 |
|---|---|---|---|
| 15599 | AZ | MD | Pharmacist |
| 051291340 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051291340 | IL | Yes |
| Pharmacist | 183500000X | 15599 | AZ |
Addresses
Primary practice location
14701 Pulaski Rd
Midlothian, IL 60445-3410
Mailing address
12497 Briarcliffe Dr
Lemont, IL 60439-4623
Other providers in Midlothian, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2011. 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.