DR. JENNIFER KAY KELLY (NPI# 1568757094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568757094 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER KAY KELLY |
| Credential | PHARM D |
| Practice Address |
6560 E State St Rockford IL 61108-2545 |
| Practice Telephone | 8152279777 |
| Mailing Telephone | 8152279777 |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2011-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051.293059 | IL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881216463 | Jennifer Kelly | Nurse Practitioner | 7595 Affirmed Ct, Lewis Center, OH 43035-9143 | 2020-05-17 |
| 1790322758 | Jennifer Lee Kelly | Home Health Aide | 4519 Stanbrook Dr, North Chesterfield, VA 23234-4021 | 2019-12-09 |
| 1396386744 | Jennifer Eileen Kelly | Specialist | 2354 Ocean Ave, Ronkonkoma, NY 11779-6578 | 2019-10-07 |
| 1659936813 | Jennifer Noel Kelly | Behavior Technician | 3287 N Mayfield Ave, San Bernardino, CA 92405-2627 | 2019-05-03 |
| 1851784284 | Jennifer Kelly | Occupational Therapy Assistant | 1215 Gainsboro Rd, Bala Cynwyd, PA 19004-2014 | 2015-03-10 |
| 1952706699 | Jennifer Kelly | Pharmacist | 1701 Welsh Rd Ste 5, Philadelphia, PA 19115-3172 | 2014-10-23 |
| 1750791257 | Jennifer Kelly | Psychologist | 11 Brooklands Apt Gi, Bronxville, NY 10708-3512 | 2014-05-06 |
| 1851722995 | Jennifer L. Kelly | Speech-Language Pathologist | 555 Anthony Wayne Trail, Waterville, OH 43566 | 2013-11-27 |
| 1144598343 | Jennifer Elaine Kelly | Physician Assistant | 381 Park Avenue South, Suite 1020, New York, NY 10016 | 2011-12-02 |
| 1063789030 | Jennifer Zucal Kelly | Registered Nurse | 215 E 5th St, Emporium, PA 15834-1417 | 2011-11-18 |
| Street Address |
6560 E STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639120488 | Charles D Pearson | Optometrist | 6560 E State St, Rockford, IL 61108-2545 | 2006-05-15 |
| 1780970988 | Joseph Raymond Fiesel | Pharmacist | 6560 E State St, T-0810, Rockford, IL 61108-2545 | 2011-06-26 |
| 1881989051 | Cherryl Sparks | Pharmacist | 6560 E State St, Rockford, IL 61108-2545 | 2011-06-15 |
| 1831483163 | Matthew Matulle | Pharmacist | 6560 E State St, T-0810, Rockford, IL 61108-2545 | 2011-06-03 |
| 1053646976 | Pearson Vision Care, Sc | Optometrist | 6560 E State St, Rockford, IL 61108-2545 | 2009-10-09 |
| 1568512200 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 6560 E State St, Rockford, IL 61108-2545 | 2007-01-12 |
| 1710909528 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 6560 E State St, Rockford, IL 61108-2545 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| 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 |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1447875604 | Paulushi Patel | Pharmacist | 2013 Mcfarland Rd, Rockford, IL 61107-6835 | 2020-06-13 |
| 1174009765 | Lynn Carlson | Pharmacist | 1672 Peconic Pl, Rockford, IL 61108-7033 | 2018-07-17 |
| 1700374568 | Zarin F Haider | Pharmacist | 2662 Elmwood Rd Ste 101, Rockford, IL 61103-1573 | 2018-04-27 |
| 1932624400 | Desmond Anthony Harold | Pharmacist | 250 Marcell Dr Ne Apt 9, Rockford, MI 49341-1380 | 2017-08-07 |
| 1528503216 | Miles Skalnek | Pharmacist | 511 10 Mile Road, Rockford, MI 49341 | 2017-01-04 |
| 1629526421 | Chi Zhang | Pharmacist | 8628 Blue River Rd, Rockford, IL 61107-5304 | 2016-09-21 |
| 1255701595 | Patrick Donohoo | Pharmacist | 291 Bienterra Trl Apt 5, Rockford, IL 61107-5890 | 2015-09-29 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1801234224 | David Thomas Storm | Pharmacist | 4404 E State St, Suite 402, Rockford, IL 61108-2115 | 2013-06-07 |
| Find all providers in ROCKFORD | ||||
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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.