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NPI Code Detail

MEDICARE: JONATHAN KYE PHARMD

MEDICARE: JONATHAN KYE 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
1183500000XPharmacist051301330IL

General Provider Information

NPI Number : 1871105601
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN KYE PHARMD
Provider Business Mailing Address
First Line : 6 E NORTH AVE
Second Line :
City : NORTHLAKE
State : IL
Zip : 60164-2516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6 E NORTH AVE
Second Line :
City : NORTHLAKE
State : IL
Zip : 60164-2516
Country : US
Telephone Number : 708-836-0348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2020
Last Update Date : 08/22/2020

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Directions to “ JONATHAN KYE PHARMD” Practice Location

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