Provider Demographics
NPI:1801081674
Name:SHUBERT, KAREN MARIE (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:SHUBERT
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 1:550 E INDUSTRIAL PARK RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966-3947
Mailing Address - Country:US
Mailing Address - Phone:618-687-9454
Mailing Address - Fax:
Practice Address - Street 1:550 E INDUSTRIAL PARK RD UNIT 1
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-3947
Practice Address - Country:US
Practice Address - Phone:618-687-9454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013571183500000X, 1835P0018X
IL0512895231835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist