Mark Joseph Kliethermes Sr., R.PH, MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

051-034080 Issued in IL

Practice address

3300 Oak Park Ave
Berwyn, IL 60402-3433

Phone

(708) 783-2411

NPI assigned

Oct 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Registered Pharmacist

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.

• Clinical Pharmacy Systems, Inc.

  • Specialist
  • Elmhurst, IL
  • NPI 1013126077
  NPD (past) Authorized official

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447240668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S KENMORE AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601263518",
            "telephone_number": "630-886-5588",
            "fax_number": "630-832-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023433",
            "telephone_number": "708-783-2411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 S Kenmore Ave",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601263518",
            "country_code": "US",
            "telephone_number": "630-886-5588",
            "fax_number": "630-206-2852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLIETHERMES",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "R.PH, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-034080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "051-034080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jisoo Kim
• Stephanie S Kim, D.O.
• Charles A Kinder, M.D.
• Christina M King, MHP
• Stacey Kitson
• Amanda L Klimczak, LMT
• Bruce Kline, MD
• Susan C. Klyber, DDS
• Kimberly Patrice Knowles
• Jacob Knupp, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.