Kenneth George, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

IL051036450 Issued in IL

Practice address

17113 Harlem Ave
Tinley Park, IL 60477-3369

Phone

(708) 532-7335

Fax

(708) 532-7391

NPI assigned

May 16, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• American Drug Stores LLC

  • Community/Retail Pharmacy
  • Tinley Park, IL
  • NPI 1265488654
  NPD (past)

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1194172585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8031 ABBEY RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604775383",
            "telephone_number": "708-614-7556",
            "fax_number": "708-532-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17113 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773369",
            "telephone_number": "708-532-7335",
            "fax_number": "708-532-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KENNETH",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "IL051036450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GBS Memorial Home Health
• F Wayne Gedutis, DDS
• Sarah Jane Geiger-Galietta, COTA/L
• Leberta Ann Gentile, RPH
• Jada George, RBT
• Natalia Gerardi
• Kelly Lynn Geritano, D.C.
• Andrew Gestautas, DPT
• Elizabeth Gezaw, PT
• Shayan Feyzi Gharagozlou, DO

• All providers in Tinley Park, IL
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; 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.