MEDICARE: MICHAEL ALAN KING PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	051037475	IL

General Provider Information

NPI Number	:	1164709317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ALAN KING PHARMD

Provider Business Mailing Address
First Line	:	4000 W 59TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-4512
Country	:	US
Telephone Number	:	773-581-2345
Fax Number	:	773-581-2948

Provider Business Practice Location Address
First Line	:	4000 W 59TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-4512
Country	:	US
Telephone Number	:	773-581-2345
Fax Number	:	773-581-2948

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	02/22/2026

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