NPIMap

Organization Active NPI

Illinois Department of Human

Doing business as Kiley Center

  • Long Term Care Pharmacy
  • Waukegan, IL
National Provider Identifier
1457404667
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
054017313 Issued in IL
Legal business name
ILLINOIS DEPARTMENT OF HUMAN
Doing business as
Kiley Center
Practice address
1401 W Dugdale Rd
Waukegan, IL 60085-6263
Phone
(847) 249-0600
Fax
(847) 249-0112
NPI assigned
Jan 19, 2007
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Jennifer Ryden, RPH
Title
Clinical Pharmacist
Phone
(217) 785-0906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Long Term Care Pharmacy 3336L0003X 054017313 IL Primary

Addresses

Primary practice location

1401 W Dugdale Rd
Waukegan, IL 60085-6263

Mailing address

1401 W Dugdale Rd
Waukegan, IL 60085-6263
Phone (847) 249-0600

Other identifiers 1

IdentifierTypeStateIssuer
2023337OtherPK

Other names 1

  • Kiley Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elisabeth Ludeman Center292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1457404667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W DUGDALE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856263",
            "telephone_number": "847-249-0600",
            "fax_number": "847-249-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W DUGDALE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856263",
            "telephone_number": "847-249-0600",
            "fax_number": "847-249-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "RYDEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CLINICAL PHARMACIST",
        "authorized_official_telephone_number": "217-785-0906",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054017313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2023337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kiley Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.