Provider Demographics
NPI:1396013868
Name:KIELAR, RONALD DENNIS (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DENNIS
Last Name:KIELAR
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28722 N SKY CREST DR
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-5305
Mailing Address - Country:US
Mailing Address - Phone:847-837-0433
Mailing Address - Fax:847-837-0696
Practice Address - Street 1:6623 N DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5101
Practice Address - Country:US
Practice Address - Phone:773-681-9175
Practice Address - Fax:773-681-9176
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.025704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist