Individual provider Active NPI

Mary Angela Kenes

  • Pharmacist
  • Orland Park, IL
National Provider Identifier
1861774853
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-036614 Issued in IL
Practice address
14680 S la Grange Rd
Orland Park, IL 60462-2510
Phone
(708) 460-2021
NPI assigned
Sep 15, 2011
Last updated
Sep 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-036614 IL Primary

Addresses

Primary practice location

14680 S la Grange Rd
Orland Park, IL 60462-2510

Mailing address

9035 Doral LN
Orland Park, IL 60462-1572
Phone (708) 349-3082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051-036614ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1861774853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 DORAL LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621572",
            "telephone_number": "708-349-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14680 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622510",
            "telephone_number": "708-460-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENES",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-036614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.