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General NPI Number Information
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NPI Number | 1831302777
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Entity Type | Individual
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Provider Name | KENNETH STANLEY KUCHAY RPH
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5610 159TH ST
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City | OAK FOREST
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State | IL
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Zip | 60452-3104
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Country | US
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Telephone | 708-687-0126
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Fax | 708-687-7853
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Provider Business Mailing Address
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Address Line | 7804 166TH ST
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City | TINLEY PARK
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State | IL
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Zip | 60477-2414
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Country | US
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Telephone | 708-633-9895
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Fax | 708-633-1631
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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 |
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License Number State | IL
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