Kelly Ha
Individual provider Active NPI Pharmacist · Highwood, IL
NPI 1215218227 · NPPES record last updated Sep 2, 2011
Key facts
- NPI
- 1215218227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051039897 (IL)
- Practice address
- 320 Waukegan Ave
Highwood, IL 60040-1313 - Phone
- (847) 433-5138
- NPI assigned
- Sep 2, 2011
- 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 |
|---|---|---|---|
| 051039897 | 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 | 051039897 | IL | Yes |
Addresses
Primary practice location
320 Waukegan Ave
Highwood, IL 60040-1313
Mailing address
320 Waukegan Ave
Highwood, IL 60040-1313
Phone (847) 433-5138
Other providers in Highwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 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.