Khaled Bleibel
Individual provider Active NPI Pharmacist · Mundelein, IL
NPI 1780161810 · NPPES record last updated Apr 7, 2022
Key facts
- NPI
- 1780161810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.301154 (IL)
- Practice address
- 951 N Il Route 83
Mundelein, IL 60060-9115 - Phone
- (847) 566-7208
- NPI assigned
- Jul 21, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.301154 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.301154 | IL | Yes |
Addresses
Primary practice location
951 N Il Route 83
Mundelein, IL 60060-9115
Mailing address
234 Greenfield Dr
Glenview, IL 60025-4817
Other practice location 1
632 Roger Williams Ave
Highland Park, IL 60035-4824
Phone (847) 432-8170
Other providers in Mundelein, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.