KMART STORES OF ILLINOIS LLC


Address: 13200 Cicero Ave, Crestwood, IL 60445-1426
Phone: 7083714132

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
54015219 IL Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 1469041 01

Other Provider/Organization Names

Other Name Type Code
KMART PHARMACY9378 Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 13200 CICERO AVE
City CRESTWOOD
State IL
Zip Code 60445-1426

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City CRESTWOOD
Zip Code 60445

Improve Information

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Dataset Information

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.

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