MEIJER GREAT LAKES LIMITED PARTNERSHIP (NPI# 1417398082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417398082 |
| Entity Type | Organization |
| Organization Name | MEIJER GREAT LAKES LIMITED PARTNERSHIP |
| Other Organization Name | MEIJER PHARMACY #265 |
| Practice Address |
9200 S Western Ave Evergreen Park IL 60805-2500 |
| Mailing Address |
2929 Walker Ave Nw Grand Rapids MI 49544-6402 |
| Practice Telephone | 7084998110 |
| Practice Fax Number | 7084998165 |
| Mailing Telephone | 6167913169 |
| Mailing Fax Number | 6167358532 |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2014-03-25 |
| Authorized Official Name | JASON BEAUCH (DIRECTOR OF PHARMACY MANAGED CARE) |
| Authorized Official Telephone | 6167913169 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 054018283 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054018283 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201193960A | 05 |
| Other Name | Type Code |
|---|---|
| Meijer Pharmacy #265 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225669641 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 541 Puri Pkwy, Sycamore, IL 60178-9029 | 2020-02-04 |
| 1962866525 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 3800 Vollmer Rd, Flossmoor, IL 60422-1274 | 2016-04-11 |
| 1891159455 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 750 E Rollins Rd, Round Lake Beach, IL 60073-1340 | 2016-04-11 |
| 1518328806 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 2951 Heartland Crossing Blvd, Owensboro, KY 42303-7669 | 2016-03-14 |
| 1114314986 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 1770 West Lane, Machesney Park, IL 61115-1627 | 2015-04-20 |
| 1205223070 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 2013 Mcfarland Road, Rockford, IL 61107-6835 | 2015-04-20 |
| 1649686056 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 11305 Lincoln Rd., Mokena, IL 60448-2070 | 2014-07-07 |
| 1346650850 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 1676 Westpark Dr., Bowling Green, KY 42104-4712 | 2014-05-06 |
| 1134556277 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 3649 N. Vermilion St., Danville, IL 61832-1312 | 2013-10-03 |
| 1013287853 | Meijer Great Lakes Limited Partnership | Durable Medical Equipment & Medical Supplies | 4200 Conestoga Dr, Springfield, IL 62711-7962 | 2012-01-11 |
| Street Address |
9200 S WESTERN AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598153173 | Kristofer Dempsey | Pharmacist | 9200 S Western Ave, Evergreen Park, IL 60805-2500 | 2015-01-05 |
| 1538579305 | Anne Knightly | Pharmacist | 9200 S Western Ave, Evergreen Park, IL 60805-2500 | 2014-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| 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 |
|---|---|---|---|---|
| 1942412119 | G & B Drugs | Pharmacy | 2850 W. 95st, Suite 100, Evergreen Park, IL 60805-2735 | 2007-05-03 |
| 1366840662 | Roundys Supermarkets Inc | Pharmacy | 2559 W 95th St, Evergreen Park, IL 60805 | 2014-12-18 |
| 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 | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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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.