Provider Demographics
NPI:1801204813
Name:CHACON, LINDSAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:CHACON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15003 S GLEN EYRIE ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-8523
Mailing Address - Country:US
Mailing Address - Phone:316-304-3163
Mailing Address - Fax:
Practice Address - Street 1:4950 ROE BLVD
Practice Address - Street 2:
Practice Address - City:ROELAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66205-1110
Practice Address - Country:US
Practice Address - Phone:913-236-2879
Practice Address - Fax:913-236-2880
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-13858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist