KELLY L MANGLER (NPI# 1649514035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649514035 |
| Entity Type | Individual |
| Full Name | KELLY L MANGLER |
| Credential | PHARM.D. |
| Practice Address |
2030 Route 34 Oswego IL 60543 |
| Practice Telephone | 6305544005 |
| Practice Fax Number | 6303837164 |
| Mailing Telephone | 6305544005 |
| Mailing Fax Number | 6303837164 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051296370 | IL | Pharmacy Service Providers |
| Street Address |
2030 ROUTE 34 |
| City | OSWEGO |
| State | IL |
| Zip Code | 60543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687332 | Graceful Therapy, LLC | Marriage & Family Therapist | 2683 Route 34, Oswego, IL 60543 | 2018-07-30 |
| 1235669763 | Elizabeth Lassandrello Bremner | Counselor | 123 W. Washington St, Oswego, IL 60543 | 2017-06-18 |
| 1205365699 | The Wisdom Shuttle, Inc. | Non-emergency Medical Transport (VAN) | 234 Springbrook Trail South, Oswego, IL 60543 | 2017-06-08 |
| 1477003267 | Smart Choice Mri, LLC | Clinic/Center | 2752 Us Highway 34, Oswego, IL 60543 | 2016-10-05 |
| 1033588686 | George Pearah | Internal Medicine | 408 Sudbury Circle, Oswego, IL 60543 | 2015-09-24 |
| 1619375078 | Kathryn Elyse Fish | Marriage & Family Therapist | 123 W Washington St Ste B-08, Oswego, IL 60543 | 2014-12-16 |
| 1821410713 | Amanda Southwell | Social Worker | 512 Affirmed Dr, Oswego, IL 60543 | 2014-01-10 |
| 1073852158 | James A. Sandrolini | Surgery | 245 Gray's Dr., Oswego, IL 60543 | 2013-02-08 |
| 1730483280 | Little Talkers, Speech and Language Therapy, LLC | Speech-Language Pathologist | 809 Barton Drive, Oswego, IL 60543 | 2010-12-27 |
| 1275847204 | Oswego East Dental Associates | Dentist | 1768 Douglas Rd, Oswego, IL 60543 | 2010-08-02 |
| Find all providers in zip 60543 | ||||
| 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 |
|---|---|---|---|---|
| 1144681586 | Ghadeer Yassin | Pharmacist | 2540 Us Highway 30, Oswego, IL 60543-8975 | 2016-03-13 |
| 1720453707 | Joshua M Adams | Pharmacist | 8 Ottawa Ct, Oswego, IL 60543-9165 | 2015-12-02 |
| 1750722989 | Ronald Kenneth Smith | Pharmacist | 63 W Seneca St, Oswego, NY 13126-1546 | 2013-07-16 |
| 1821344094 | Richard James Bova | Pharmacist | 341 Route 104 East, Oswego, NY 13126 | 2012-07-25 |
| 1952681777 | Maria F Chinikailo | Pharmacist | 341 State Route 104e, Oswego, NY 13126 | 2011-08-24 |
| 1417245911 | Benjamin C Frary | Pharmacist | 192 West 1st Street, Oswego, NY 13126 | 2011-07-18 |
| 1528353265 | Robert John Lullo | Pharmacist | 2700 Route 34, #239, Oswego, IL 60543-7118 | 2011-06-10 |
| 1639479058 | Thomas Henry Funk | Pharmacist | 3010 Route 34, Oswego, IL 60543-8333 | 2010-11-01 |
| 1275856585 | Karen Lee Komarnicki | Pharmacist | 341 St Ate Route 104 E, Oswego, NY 13126 | 2010-03-02 |
| 1609198225 | Kimberly Ann Mahajan | Pharmacist | 341 Star Rt 104 E, Oswego, NY 13126-2911 | 2010-02-23 |
| Find all providers in OSWEGO | ||||
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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.