HIGHLAND PARK CVS LLC (NPI# 1124041405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124041405 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS LLC |
| Other Organization Name | CVS PHARMACY #16306 |
| Practice Address |
5071 Cal Sag Rd Crestwood IL 60445-1458 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7083853199 |
| Practice Fax Number | 7082979953 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-08-29 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054.019717 | IL | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2022216 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16306 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972116499 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 4631 W Foster Ave, Chicago, IL 60630 | 2020-08-25 |
| 1558974071 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 W Webster Ave, Chicago, IL 60614-7610 | 2020-08-25 |
| 1669002135 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 2434 N Sacramento Ave, Chicago, IL 60647-2666 | 2020-01-23 |
| 1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1316428147 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 739 Roosevelt Rd, Glen Ellyn, IL 60137-5877 | 2018-08-29 |
| 1124520424 | Highland Park Cvs LLC | Pharmacy | 110 E Norris Dr, Ottawa, IL 61350-1515 | 2018-03-02 |
| 1326555236 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 678 N Wells St, Chicago, IL 60654-3717 | 2018-01-02 |
| 1174040687 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 3300 N Ashland Ave, Chicago, IL 60657-2109 | 2017-08-25 |
| 1538686357 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1129 Lake St., Oak Park, IL 60301 | 2017-08-23 |
| Street Address |
5071 CAL SAG RD |
| City | CRESTWOOD |
| State | IL |
| Zip Code | 60445-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235409137 | Jennifer Kathleen Donovan | Pharmacist | 5071 Cal Sag Rd, (t-0868), Crestwood, IL 60445-1458 | 2012-01-09 |
| 1376838631 | Samuel Raymond Harper | Pharmacist | 5071 Cal Sag Rd, Crestwood, IL 60445-1458 | 2011-06-15 |
| 1497061832 | Brent Herbert Brokhof | Pharmacist | 5071 Cal Sag Rd, Crestwood, IL 60445-1458 | 2010-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861911398 | Paula Marie Jensen Hallahan | Psychologist | Hermansen Elementary School, 101 Wesglen Parkway, Romeoville, IL 60445 | 2017-09-15 |
| 1861933756 | Reginald Castillo | Emergency Medical Technician, Paramedic | 4939 East Circle Dr. #206, Crestwood, IL 60445 | 2017-03-13 |
| 1801259684 | Bruce Frank Leo | Hearing Instrument Specialist | 5553 W. 127th St, Crestwood, IL 60445 | 2016-03-30 |
| 1801291687 | Annie Eyer | Behavioral Analyst | 4942 138th Place, Crestwood, IL 60445 | 2014-10-23 |
| 1679997266 | Phoenix Behavioral Services, Inc | Case Management | 4649 147th Street, Midlothian, IL 60445 | 2014-02-18 |
| 1841537149 | Lacy Carol Little | Speech-Language Pathologist | 14715 Leclaire Ave., Midlothian, IL 60445 | 2013-01-08 |
| 1164709291 | Kathleen Chaudhari | Pharmacist | 4800 W 148th Street, Midlothian, IL 60445 | 2011-11-03 |
| 1063715498 | Amanda Rea Bird | Behavioral Analyst | 5415 129th Pl, Apt 4, Crestwood, IL 60445 | 2010-12-07 |
| 1831376615 | Plaza Nursing & Rehab Center, LLC | Durable Medical Equipment & Medical Supplies | 3249 W 147th St, Midlothiian, IL 60445 | 2008-01-24 |
| 1154475630 | Kevin Martin Bargamian | Dentist | 13549 South Cicero Avenue, Crestwood, IL 60445 | 2007-01-22 |
| Find all providers in zip 60445 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447668934 | Towncare Pharmacy LLC | Pharmacy | 13805 Cicero Ave, Crestwood, IL 60418-1826 | 2014-07-28 |
| 1740512094 | Medication Management Partners | Pharmacy | 13601 Kenton Ave, Crestwood, IL 60418-1938 | 2010-02-10 |
| 1396776456 | Kmart Stores of Illinois LLC | Pharmacy | 13200 Cicero Ave, Crestwood, IL 60445-1426 | 2006-07-06 |
| 1083643050 | Safeway Inc | Pharmacy | 13180 Cicero Ave, Crestwood, IL 60445-1470 | 2006-07-02 |
| 1710343611 | Wal-mart Stores East Lp | Pharmacy | 6501 Veterans Memorial Pkwy, Crestwood, KY 40014-8694 | 2016-01-07 |
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|---|---|---|---|---|
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| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
| 1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
| 1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
| 1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
| 1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
| 1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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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.