ILLINI CLINIC PHARMACY INC


Address: 103 N Prospect St, Cambridge, IL 61238-1148
Phone: 3097815770

ILLINI CLINIC PHARMACY INC (NPI# 1871110254) 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) 1871110254
Entity Type Organization
Organization Name ILLINI CLINIC PHARMACY INC
Practice Address 103 N Prospect St
Cambridge
IL 61238-1148
Mailing Address 855 Illini Dr Ste 200
Silvis
IL 61282-2908
Practice Telephone 3097815770
Mailing Telephone 0937927002
Enumeration Date 2020-07-01
Last Update Date 2020-07-01
Authorized Official Name DONNA MERIDETH (OWNER)
Authorized Official Telephone 3097815770
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
IL CONTROLLED SUBSTANCE LICENSE 320-013281 01
IL STATE LICENSE 054-021593 01

Other Provider/Organization Names

Other Name Type Code
RidgeWood Pharmacy Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1992265235 Illini Clinic Pharmacy Inc Pharmacy 211 S 1st Street, Alpha, IL 61413 2019-03-22
1750841342 Illini Clinic Pharmacy Inc Pharmacy 855 Illini Dr Ste 200, Silvis, IL 61282-2904 2019-03-21
1053838458 Illini Clinic Pharmacy Inc Pharmacy 211 S. 1st St, Alpha, IL 61413-0355 2017-08-25
1356561039 Illini Clinic Pharmacy Inc Pharmacy 855 Illini Dr, Suite 200, Silvis, IL 61282-2907 2007-04-26

Office Location

Street Address 103 N PROSPECT ST
City CAMBRIDGE
State IL
Zip Code 61238-1148

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164567962 Rose Ann Schneider Technician 603 N Prospect St, 114, Cambridge, IL 61238-1049 2007-02-20
1063448462 Iowa Physicians Clinic Medical Foundation Durable Medical Equipment & Medical Supplies 106 N East St, Cambridge, IL 61238-1157 2006-06-25
1184785560 John Leonard Guild Chiropractor 117 S East St, Cambridge Chiropractic, Cambridge, IL 61238-1221 2006-12-12
1215060330 Cambridge Fire Protection District Ambulance 303 S. East Road, Cambridge, IL 61238-1308 2007-03-14
1013315829 Stephanie Morgan Taylor Massage Therapist 411 South Rd, Cambridge, IL 61238-1402 2014-12-10
1053874024 Vibrant Health Chiropractic LLC Chiropractor 411 South Rd, Cambridge, IL 61238-1402 2019-04-08
1093231706 Crystal Jayne Strode Chiropractor 411 South Rd, Cambridge, IL 61238-1402 2017-08-15
1619523396 Jennifer Megann Erickson Speech-Language Pathologist 312 S West St, Cambridge, IL 61238-1430 2019-08-17
1538361092 Cambridge Cusd 227 Local Education Agency (LEA) 300 S West St, Cambridge, IL 61238-1430 2007-06-05

Providers in the same city

NPI Name Taxonomy Address Enumeration
1215538269 Jolene Potter Physical Therapist 32 Prospect St, Cambridge, MA 02139-2401 2020-11-05
1770182230 Elizabeth Anne Sutera Nurse Practitioner 725 Concord Ave Ste 3200, Cambridge, MA 02138-1092 2020-10-25
1730788324 Debra Merle Baker Massage Therapist 10 Holworthy Pl, Cambridge, MA 02138-4510 2020-10-23
1316546294 Steacy Lynne Suddaby Nurse Practitioner 272 N Main Street, Suite 101, Cambridge, VT 05444-0102 2020-10-21
1346849619 Judith Olden Home Health Aide 807 N7th St., Cambridge, OH 43725 2020-10-19
1669070389 Theresa Howe Registered Nurse 148 Gore St, Cambridge, MA 02141-1135 2020-10-14
1659979615 Ruth Carter Homemaker 9808 Ohio Ave, Cambridge, OH 43725-9313 2020-10-13
1982202032 Makayla Davis Social Worker 43 Kinnaird St, Cambridge, MA 02139-3127 2020-10-12
1225636558 Agnprx LLC Nurse Practitioner 5543 Bonnie Brook Rd, Cambridge, MD 21613-3437 2020-10-09
1558968784 Francina Alvarez Noboa Dentist 700 Huron Ave Apt 15m, Cambridge, MA 02138-4590 2020-10-01
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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
1437299609 Hubbard's Pharmacy, Inc Pharmacy 636 Race St, Cambridge, MD 21613-2351 2007-02-07
1952400301 Cvs Pharmacy Inc Pharmacy 6 Jfk St, Cambridge, MA 02138-4909 2006-09-22
1063511426 Cvs Pharmacy Inc Pharmacy 624 Massachusetts Ave, Cambridge, MA 02139-3307 2006-09-22
1093814600 Inman Pharmacy, Inc Pharmacy 1414 Cambridge Street, Cambridge, MA 02139 2006-09-21
1659474310 Revco Discount Drug Centers Inc Pharmacy 626 Sunburst Hwy, Cambridge, MD 21613 2006-09-07
1992808612 Ohio Cvs Stores LLC Pharmacy 1116 Wheeling Ave, Cambridge, OH 43725-2508 2006-09-07
1578578704 Walgreen Co Pharmacy 115 Garfield St N, Cambridge, MN 55008-1765 2006-07-29
1255346466 Walgreen Co Pharmacy 625 Massachusetts Ave, Cambridge, MA 02139-3357 2006-07-29
1588689137 The Great Atlantic and Pacific Tea Company Inc Pharmacy 780 Cambridge Plz, Cambridge, MD 21613-2531 2006-07-13
1588663074 Riesbeck Food Markets, Inc. Pharmacy 55 S 23rd St, Cambridge, OH 43725-2180 2005-07-18
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Competitor

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City CAMBRIDGE
Zip Code 61238

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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