Kristin Dwyer, PHARMD

Individual provider Active NPI Pharmacist · Peru, IL

NPI 1225446032 · NPPES record last updated Aug 1, 2014

Key facts

NPI
1225446032
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
051297632 (IL)
Practice address
1033 Shooting Park Rd
Peru, IL 61354-1870
Phone
(815) 223-7853
NPI assigned
Jul 24, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

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

LicenseStateTypeSpecialty
051297632ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Hearing LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051297632 IL Yes

Addresses

Primary practice location

1033 Shooting Park Rd
Peru, IL 61354-1870

Mailing address

12803 Reese Rd
Spring Valley, IL 61362-9008
Phone (515) 720-3448

Other providers in Peru, IL

All providers in Peru, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.