Kedvon Pharmacy Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KEDVON PHARMACY INC

Practice address

62 S Milwaukee Ave
Wheeling, IL 60090-3108

Phone

(773) 338-7171

Fax

(773) 338-7272

NPI assigned

Sep 30, 2005

Organization subpart

No

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

Authorized official

Name

Vladlena Korol, PHARMDNPI 1730384629

Title

Owner

Phone

(773) 338-7171

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• KEDVON PHARMACY INC Doing business as
• Kedvon Health, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vladlena Korol, PHARMD

  • Pharmacist
  • Wheeling, IL
  • NPI 1730384629
  NPD (past) Authorized official

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613779200000",
    "number": "1861489353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 S MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903108",
            "telephone_number": "773-338-7171",
            "fax_number": "773-338-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 S MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903108",
            "telephone_number": "773-338-7171",
            "fax_number": "773-338-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2763 W Devon Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606591712",
            "country_code": "US",
            "telephone_number": "773-338-7171",
            "fax_number": "773-338-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEDVON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A",
        "authorized_official_last_name": "KOROL",
        "authorized_official_first_name": "VLADLENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-338-7171",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1466831",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KEDVON PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KEDVON PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kedvon Health, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• JZ Vision LLC
• Kaylee Shea Kalvig
• Ji Min Kang
• David Robert Kaplan, L.C.P.C.
• Mary Voight Kay, MS
• Kedvon Pharmacy Solutions, Inc.
• Peggy Patrizia Keese, MA
• Kenneth Portnoy
• Lindsey Sarah Kessler, MA
• Tatyana Khait, DDS

• Durable Medical Equipment & Medical Supplies in Wheeling, IL
• Providers in Wheeling, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.