Healthcare Provider Details

I. General information

NPI: 1386558922
Provider Name (Legal Business Name): MACKENZIE BEAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

948 LAKERIDGE CT
SUGAR GROVE IL
60554-9264
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051308886
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: