Adam David Kellen, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051304940 Issued in IL

Practice address

1800 Vandalia St
Collinsville, IL 62234-4844

Phone

(618) 344-8473

NPI assigned

Oct 26, 2022

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

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.

• Highland Park CVS LLC

  • Pharmacy
  • Collinsville, IL
  • NPI 1740589878
  NPD (past)

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1316664691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CHAPEL DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344335",
            "telephone_number": "815-780-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 VANDALIA ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344844",
            "telephone_number": "618-344-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEN",
        "first_name": "ADAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051304940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janae Cambriel Jones, PTA
• Shonika Deneen Jones
• Ryan A Jouett, LCPC, LPC
• David Charles Juelfs, MSW, LCSW
• Kathyrn Renee Karouzos, M.S., L.P.C.
• Kenneth S. Kollmann, D.M.D.,P.C.
• Curtis Knolhoff
• Tatiana M Kokotovich
• Kenneth Scott Kollmann, D.M.D.
• Tiffany Cason Kornmann, MSW, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.