Provider Demographics
NPI:1487227898
Name:KS PHARMACY
Entity Type:Organization
Organization Name:KS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:KAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACULEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:312-319-2729
Mailing Address - Street 1:645 N KINGSBURY ST APT 1804
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-6873
Mailing Address - Country:US
Mailing Address - Phone:847-610-0144
Mailing Address - Fax:
Practice Address - Street 1:1141 W MADISON ST STE 33
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2048
Practice Address - Country:US
Practice Address - Phone:312-319-2729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy