Breanne Marie Knightly, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.303980 Issued in IL

Practice address

17113 Harlem Ave
Tinley Park, IL 60477-3369

Phone

(708) 532-7477

Fax

(708) 532-7391

NPI assigned

Jul 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

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.

• American Drug Stores LLC

  • Community/Retail Pharmacy
  • Diamond, IL
  • NPI 1013786706
  NPD (past)
• American Drug Stores LLC

  • Community/Retail Pharmacy
  • Tinley Park, IL
  • NPI 1265488654
  NPD (past)

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1780257527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 S CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606553111",
            "telephone_number": "773-633-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17113 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773369",
            "telephone_number": "708-532-7477",
            "fax_number": "708-532-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHTLY",
        "first_name": "BREANNE",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.303980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kissane, MPT
• Brad Edward Kleine, ATC, NASM-PES
• Tracy Klimek
• Theresa Kniepmann, SLP
• Frank J. Kniffen, M.D.
• Stewart C Knoop Jr., O.D.
• Jennifer P Koch, DMD
• Kimberlee Koehler
• Amy Koenig, RBT
• Amanda Koerber

• All providers in Tinley Park, IL
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.