Provider Demographics
NPI:1619525417
Name:CONLEY, KATHRYN LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LYNN
Last Name:CONLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LYNN
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1800 N WASHTENAW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4220
Mailing Address - Country:US
Mailing Address - Phone:708-642-1488
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1443
Practice Address - Country:US
Practice Address - Phone:773-702-1220
Practice Address - Fax:773-834-4880
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.302251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist