KELLY MARIE COSTELLO (NPI# 1194237495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194237495 |
| Entity Type | Individual |
| Full Name | KELLY MARIE COSTELLO |
| Practice Address |
1200 W Fayette Ave Effingham IL 62401-1913 |
| Practice Telephone | 2173426075 |
| Mailing Telephone | 2173426075 |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051300725 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194177949 | Kelly Lynn Costello | Behavioral Analyst | 4103 Lester Ct, Alexandria, VA 22311-1121 | 2016-07-05 |
| 1295192268 | Kelly Costello | Developmental Therapist | 1501 Frost Rd, Mechanicsburg, PA 17055-5134 | 2016-01-21 |
| 1659507226 | Kelly N Costello | Occupational Therapist | 4622 40th Ave S Ste B, Fargo, ND 58104-4394 | 2009-06-09 |
| 1497159412 | Kelly Costello | Counselor | 1714 Jarrettsville Rd, Jarrettsville, MD 21084-1524 | 2014-10-20 |
| 1780011932 | Kelly Costello | Social Worker | 2500 18th St, San Francisco, CA 94110-2109 | 2013-10-02 |
| 1588858039 | Kelly L Costello | Dietitian, Registered | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2007-08-28 |
| 1639389448 | Kelly E Costello | Counselor | 95 Pleasant St, Lynn, MA 01901-1524 | 2007-05-23 |
| 1801828884 | Kelly L Costello | Pediatrics | 401 N 17th St, Suite 203, Allentown, PA 18104-5034 | 2006-07-07 |
| Street Address |
1200 W FAYETTE AVE |
| City | EFFINGHAM |
| State | IL |
| Zip Code | 62401-1913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992710180 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2006-07-29 |
| 1801428628 | Taylor Elizabeth Hutchison | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2020-02-10 |
| 1417460767 | Philip Han | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2017-11-08 |
| 1235674474 | Yesul Kim | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2016-12-26 |
| 1457604258 | Renee Deimel | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2012-10-18 |
| 1417230368 | Nicholas Kenny | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2011-09-27 |
| 1366724148 | Nicole Marie Yocum | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2011-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568021269 | Rhodes To Health, LLC | Chiropractor | 200 E. Fayette Ave, Effingham, IL 62401 | 2019-06-07 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1033632187 | Diel Counseling Inc. | Counselor | 444 S. Willow #7, Effingham, IL 62401 | 2017-07-20 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1194107102 | Radhika Annam | Internal Medicine | 500 N. Maple St., Joslin Diabetes Center Affiliate At Hshs Medical Group, Effingham, IL 62401 | 2015-06-25 |
| 1912334558 | Ruben Boyajian, Md | Surgery | 904 Medical Park Drive, Suite 2, Effingham, IL 62401 | 2013-09-27 |
| 1427483502 | Daniel E Czajkowski | Physical Therapist | 2611 S Banker St, Effingham, Il, Effingham, IL 62401 | 2013-09-09 |
| 1093140501 | Lifetime Dental Care of Maryland, Badger, P.C. | Dentist | 1200 Network Centre Drive, Suite #2, Effingham, IL 62401 | 2013-09-04 |
| 1689926487 | Wellness Loft Inc. | Counselor | 408 South 4th St., Effingham, IL 62401 | 2012-10-04 |
| 1598011470 | Patricia R. Diel | Social Worker | 444 S. Willow, Suite 7, Effingham, IL 62401 | 2012-07-30 |
| Find all providers in zip 62401 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779119 | Crystal Renee Hoene | Pharmacist | 1204 Ave of Mid America, Effingham, IL 62401-4715 | 2020-10-26 |
| 1396345732 | Tracie Elizabeth Petzing | Pharmacist | 1204 Ave of Mid America Ste 2, Effingham, IL 62401-4716 | 2020-10-26 |
| 1609271345 | Andrew Slavens | Pharmacist | 105 Greenview Dr Apt 7a, Effingham, IL 62401-3076 | 2014-10-23 |
| 1386066538 | Donna Marie Woelfer | Pharmacist | 1012 Northwood Dr, Effingham, IL 62401-4566 | 2014-01-07 |
| 1265700553 | Phillip Arthur Conlin | Pharmacist | 108 E Hawthorne Dr, Effingham, IL 62401-4130 | 2011-12-01 |
| 1629351663 | Kimberly Jill Elmore | Pharmacist | 2006 Magnolia St, Effingham, IL 62401-4914 | 2011-09-26 |
| 1205168481 | Tal M Rozene | Pharmacist | 1006 N Keller Dr, Effingham, IL 62401-1743 | 2010-02-12 |
| 1144820051 | Marsha A Turner | Pharmacist | 1204 Avenue of Mid America, Effingham, IL 62401-4715 | 2020-10-29 |
| 1447850573 | Nicole Slavens | Pharmacist | 1204 Ave of Mid America, Effingham, IL 62401-4715 | 2020-10-28 |
| 1801428628 | Taylor Elizabeth Hutchison | Pharmacist | 1200 W Fayette Ave, Effingham, IL 62401-1913 | 2020-02-10 |
| Find all providers in EFFINGHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.