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General NPI Number Information
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NPI Number | 1487249439
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Entity Type | Individual
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Provider Name | KRISTY O'BRIEN PHARM D
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 11859 SOUTHWEST HWY
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1017
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Country | US
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Telephone | 773-895-9394
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Fax |
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Provider Business Mailing Address
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Address Line | 220 S MADISON AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-2342
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Country | US
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Telephone | 773-895-9394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051289047
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License Number State | IL
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