Provider Demographics
NPI:1508087008
Name:SWIFT, KATHERINE N (RPH CGP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:N
Last Name:SWIFT
Suffix:
Gender:F
Credentials:RPH CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27718 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:ISLAND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60042-8415
Mailing Address - Country:US
Mailing Address - Phone:847-526-6660
Mailing Address - Fax:
Practice Address - Street 1:2211 SANDERS RD
Practice Address - Street 2:NBT 15-2N
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6150
Practice Address - Country:US
Practice Address - Phone:847-559-5654
Practice Address - Fax:847-559-4949
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-0301041835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric