Richard Jeffrey Kiebala, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051295666 Issued in IL

Practice address

4801 N Central Ave
Chicago, IL 60630-3211

Phone

(773) 282-2828

Fax

(773) 282-9120

NPI assigned

Nov 16, 2020

Last updated

Nov 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1275135048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303211",
            "telephone_number": "773-282-2828",
            "fax_number": "773-282-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303211",
            "telephone_number": "773-282-2828",
            "fax_number": "773-282-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEBALA",
        "first_name": "RICHARD",
        "middle_name": "JEFFREY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Chicago, IL
• Providers in Chicago, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.