KMART STORES OF ILLINOIS LLC (NPI# 1396776456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396776456 |
Entity Type | Organization |
Organization Name | KMART STORES OF ILLINOIS LLC |
Other Organization Name | KMART PHARMACY9378 |
Practice Address |
13200 Cicero Ave Crestwood IL 60445-1426 |
Mailing Address |
3333 Beverly Rd Ac 367 B Hoffman Estates IL 60179-0001 |
Practice Telephone | 7083714132 |
Practice Fax Number | 7083719059 |
Mailing Telephone | 8472864089 |
Mailing Fax Number | 8472861603 |
Enumeration Date | 2006-07-06 |
Last Update Date | 2009-06-19 |
Authorized Official Name | ROBBERT AYSHFORD (DIVISIONAL VICE PRESIDENT) |
Authorized Official Telephone | 8472868242 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
54015219 | IL | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1469041 | 01 |
Other Name | Type Code |
---|---|
KMART PHARMACY9378 | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679504724 | Kmart Stores of Illinois LLC | Pharmacy | 1608 36th St, Peru, IL 61354-1273 | 2006-07-06 |
1215968367 | Kmart Stores of Illinois LLC | Pharmacy | 10205 Grand Ave, Franklin Park, IL 60131-3138 | 2006-07-06 |
1548291602 | Kmart Stores of Illinois LLC | Pharmacy | 1500 W Maple St, New Lenox, IL 60451-1529 | 2006-07-06 |
1033140199 | Kmart Stores of Illinois LLC | Pharmacy | Vermillion Plaza, Pontiac, IL 61764 | 2006-07-06 |
1811928971 | Kmart Stores of Illinois LLC | Pharmacy | 840 Plainfield Rd, Willowbrook, IL 60527-5340 | 2006-07-06 |
1437180593 | Kmart Stores of Illinois LLC | Pharmacy | 2235 S Eastwood Dr, Woodstock, IL 60098-4606 | 2006-07-06 |
1124059282 | Kmart Stores of Illinois LLC | Pharmacy | 2700 Plainfield Rd, Joliet, IL 60435-1165 | 2006-07-06 |
1801828652 | Kmart Stores of Illinois LLC | Pharmacy | 11000 S Cicero Ave, Oak Lawn, IL 60453-5504 | 2006-07-06 |
1497786545 | Kmart Stores of Illinois LLC | Pharmacy | 901 W Lake Ave, Peoria, IL 61614-5968 | 2006-07-06 |
1942231097 | Kmart Stores of Illinois LLC | Pharmacy | 5909 E State St, Rockford, IL 61108-2429 | 2006-07-06 |
Street Address |
13200 CICERO AVE |
City | CRESTWOOD |
State | IL |
Zip Code | 60445-1426 |
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 | 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 |
---|---|---|---|---|
1386153328 | Heal Rx Pharmacy LLC | Pharmacy | 14120 Cicero Ave, Crestwood, IL 60418-2153 | 2017-09-21 |
1871697722 | Kentucky Cvs Pharmacy, L.L.C. | Pharmacy | 6425 W Highway 146, Crestwood, KY 40014-9575 | 2006-09-12 |
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 |
1386242352 | Letitride, Inc. | Pharmacy | 501 W Oak Street, Fairbury, IL 61739 | 2020-10-13 |
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 |
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.