Provider Demographics
NPI:1427339456
Name:KAHL, SHEILA R (RPH)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:R
Last Name:KAHL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 WATERFORD WAY
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5803
Mailing Address - Country:US
Mailing Address - Phone:847-263-7294
Mailing Address - Fax:
Practice Address - Street 1:305 W ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-1217
Practice Address - Country:US
Practice Address - Phone:847-546-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287124183500000X
WI11347040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist