Individual provider Active NPI

Kimberly Catledge, PHARMD

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1164790010
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.291162 Issued in IL
Practice address
11 E 75TH St
Chicago, IL 60619-1601
Phone
(773) 224-1211
NPI assigned
Dec 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.291162 IL Primary

Addresses

Primary practice location

11 E 75TH St
Chicago, IL 60619-1601

Mailing address

17398 Brook Crossing LN
Orland Park, IL 60467-8508
Phone (708) 479-0451

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.291162ILMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1164790010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17398 BROOK CROSSING LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678508",
            "telephone_number": "708-479-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606191601",
            "telephone_number": "773-224-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATLEDGE",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.291162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.