HIGHLAND PARK CVS, L.L.C (NPI# 1154491884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154491884 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C |
| Other Organization Name | CVS PHARMACY #10624 |
| Practice Address |
902 E Oak St Fairbury IL 61739 |
| Mailing Address |
1 Cvs Dr Woonsocket RI 02895-6146 |
| Practice Telephone | 8156922132 |
| Practice Fax Number | 8156922393 |
| Mailing Telephone | (401) 765-1500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | SUSAN COLBERT (SR. DR. 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 | 20300849 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054-016042 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NABP | 14-79888 | 01 | |
| IL | STATE PHARMACY LIC | 054-016042 | 01 |
| IL | 363484164024 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #10624 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770035636 | Highland Park Cvs, L.l.c | Registered Nurse | 10405 N Centerway Dr, Peoria, IL 61615-1233 | 2016-10-26 |
| 1134578354 | Highland Park Cvs, L.l.c | Pharmacy | 2650 N Clark St, Chicago, IL 60614-1523 | 2016-06-08 |
| 1558446633 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 106 Watters Dr, Dwight, IL 60420 | 2006-10-26 |
| 1649355660 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 1101 S. Water St., Wilmington, IL 60481 | 2006-10-26 |
| 1093819948 | Highland Park Cvs, L.l.c | Pharmacy | 7855 S Western Ave, Chicago, IL 60620-5823 | 2006-09-12 |
| 1497790406 | Highland Park Cvs, L.l.c | Registered Nurse | 4800 N University St, Peoria, IL 61614-5891 | 2006-06-17 |
| Street Address |
902 E OAK ST |
| City | FAIRBURY |
| State | IL |
| Zip Code | 61739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659704740 | Julie Patten | Pharmacist | 902 E Oak St, Fairbury, IL 61739-1390 | 2013-08-13 |
| 1124341250 | Michelle L. Miller | Specialist/Technologist | 902 E Oak St, Suite 3, Fairbury, IL 61739-1390 | 2010-03-03 |
| 1689830721 | Melissa A Eshleman | Pharmacist | 902 E Oak St, Fairbury, IL 61739-1390 | 2008-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| 1316101025 | Tracy Neal Taylor | Dentist | 202 East Locust Street, Fairbury, IL 61739 | 2008-07-11 |
| 1255748745 | Brenton Waystout | Nurse Practitioner | 115 E Walnut St, Fairbury, IL 61739 | 2014-07-16 |
| 1740354117 | Henry John Handler | Dentist | 110 N 2nd St, Fairbury, IL 61739-1116 | 2006-11-20 |
| 1033687843 | Nu-atrics: Pediatric Nutrition & Wellness LLC | Durable Medical Equipment & Medical Supplies | 211 W Willow St, Fairbury, IL 61739-1172 | 2018-11-09 |
| 1114987161 | Fairview Haven Inc | Skilled Nursing Facility | 605 N 4th St, Fairbury, IL 61739-1210 | 2006-03-24 |
| 1336306570 | Prairie Central Cusd No 8 | Local Education Agency (LEA) | 605 N 7th St, Fairbury, IL 61739-1300 | 2008-05-16 |
| 1114313467 | Champion Fitness, Inc | Clinic/Center | 902 E Oak St Ste 3, Fairbury, IL 61739-1301 | 2015-04-14 |
| 1073520334 | Scott John Nowak | Chiropractor | 401 S Clay St, Fairbury, IL 61739-1481 | 2006-08-01 |
| 1568865707 | Fairbury Chiropractic Clinic PC | Chiropractor | 401 S Clay St, Fairbury, IL 61739-1481 | 2014-10-02 |
| Find all providers in zip 61739 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538582 | Wilmington Pharmacy LLC | Pharmacy | 600 W Baltimore St, Wilmington, IL 60481-1281 | 2020-11-03 |
| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1699389890 | J2sb LLC | Pharmacy | 398 W Army Trail Rd Ste 120, Bloomingdale, IL 60108-2398 | 2020-09-04 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1710599485 | Costco Wholesale Corporation | Pharmacy | 16261 S Boulevard Pl, Plainfield, IL 60586-4400 | 2020-08-23 |
| 1982212635 | Grand Pharmacy LLC | Pharmacy | 229 W Grand Ave Ste F, Bensenville, IL 60106-3365 | 2020-07-20 |
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 1831716745 | The Project of The Quad Cities | Pharmacy | 1701 River Dr Ste 106, Moline, IL 61265-1384 | 2020-06-26 |
| 1518581784 | Biovita Pharmacy Inc. | Pharmacy | 955 W 75th St, Naperville, IL 60565-6189 | 2020-06-03 |
| 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.