Individual provider Active NPI

Kristi Markuson, RPH

  • Pharmacist
  • Lake in the Hills, IL
National Provider Identifier
1407450869
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051039034 Issued in IL
Practice address
250 N Randall Rd
Lake in the Hills, IL 60156-5943
Phone
(847) 960-9937
NPI assigned
Nov 25, 2020
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051039034 IL Primary

Addresses

Primary practice location

250 N Randall Rd
Lake in the Hills, IL 60156-5943

Mailing address

31190 N Jensen LN
Libertyville, IL 60048-1134
Phone (847) 848-7408

Other practice location 1

3050 N Lewis Ave
Waukegan, IL 60087-2231
Phone (847) 599-9079

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051039034ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1407450869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31190 N JENSEN LN",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481134",
            "telephone_number": "847-848-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N RANDALL RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565943",
            "telephone_number": "847-960-9937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3050 N Lewis Ave",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600872231",
            "country_code": "US",
            "telephone_number": "847-599-9079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKUSON",
        "first_name": "KRISTI",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051039034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

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