Healthcare Provider Details

I. General information

NPI: 1356110969
Provider Name (Legal Business Name): KEDVON PHARMACY INTEGRATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 BUFFALO GROVE RD
BUFFALO GROVE IL
60089-3708
US

IV. Provider business mailing address

770 BUFFALO GROVE RD
BUFFALO GROVE IL
60089-3708
US

V. Phone/Fax

Practice location:
  • Phone: 847-947-2601
  • Fax:
Mailing address:
  • Phone: 847-947-2601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VLADLENA KOROL
Title or Position: PRESIDENT
Credential:
Phone: 847-322-8275