HIGHLAND PARK CVS, L.L.C (NPI# 1558446633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558446633 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C |
| Practice Address |
106 Watters Dr Dwight IL 60420 |
| Mailing Address |
1 Cvs Dr Woonsocket RI 02895-6146 |
| Practice Telephone | 8155842140 |
| Practice Fax Number | 8155841722 |
| Mailing Telephone | (401) 765-1500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2017-08-08 |
| 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 | 203000678 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054-011925 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PHARMACY LIC | 054-011925 | 01 |
| IL | 363484164004 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #10607 | 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 |
| 1154491884 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 902 E Oak St, Fairbury, IL 61739 | 2006-11-09 |
| 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 |
106 WATTERS DR |
| City | DWIGHT |
| State | IL |
| Zip Code | 60420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114453768 | Naila A O'connell | Nurse Practitioner | 106 Watters Dr, B, Dwight, IL 60420-2200 | 2017-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902149982 | Maulin G Shah | Family Medicine | 107 Watters Dr, Dwight, IL 60420 | 2013-03-28 |
| 1861598997 | Cynthia Ann Humbert | Dentist | 413 E Mazon Ave, Dwight, IL 60420 | 2006-09-16 |
| 1851404313 | Mark A Passerman | Family Medicine | 101 S Prairie Ave, Dwight, IL 60420 | 2006-08-17 |
| 1528174489 | Bradford R Egly | Podiatrist | 108 W Main St, Dwight, IL 60420 | 2006-08-22 |
| 1558820829 | Laura E Lamere | Occupational Therapy Assistant | 215 E North St, Dwight, IL 60420-1051 | 2019-03-17 |
| 1982695029 | Heritage Manor Dwight, LLC | Durable Medical Equipment & Medical Supplies | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2005-10-28 |
| 1194280024 | Matthew J Govednik | Physical Therapy Assistant | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2019-02-05 |
| 1215346036 | Kelly Martin | Occupational Therapist | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2014-08-06 |
| 1487061974 | Debra Wilder | Physical Therapy Assistant | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2014-07-16 |
| 1083021612 | Ericka L Stemple | Occupational Therapy Assistant | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2014-07-15 |
| Find all providers in zip 60420 | ||||
| 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 |
|---|---|---|---|---|
| 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.