Individual provider Active NPI

Ronald Dennis Kielar, PHARMACIST

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1396013868
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.025704 Issued in IL
Practice address
6623 N Damen Ave
Chicago, IL 60645-5101
Phone
(773) 681-9175
Fax
(773) 681-9176
NPI assigned
Dec 12, 2011
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.025704 IL Primary

Addresses

Primary practice location

6623 N Damen Ave
Chicago, IL 60645-5101

Mailing address

28722 N Sky Crest Dr
Mundelein, IL 60060-5305
Phone (847) 837-0433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051.025704ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1396013868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28722 N SKY CREST DR",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600605305",
            "telephone_number": "847-837-0433",
            "fax_number": "847-837-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6623 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455101",
            "telephone_number": "773-681-9175",
            "fax_number": "773-681-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELAR",
        "first_name": "RONALD",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.025704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.