PETERSONS PERSCRIPTION PHARMACY INC (NPI# 1053322552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053322552 |
| Entity Type | Organization |
| Organization Name | PETERSONS PERSCRIPTION PHARMACY INC |
| Other Organization Name | PETERSONS PRESCRIPTION PHARMACY |
| Practice Address |
715 Lake St Oak Park IL 60301-1467 |
| Practice Telephone | 7088485020 |
| Practice Fax Number | 7088485022 |
| Mailing Telephone | 7088485020 |
| Mailing Fax Number | 7088485022 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2012-08-31 |
| Authorized Official Name | WILLIAM ELICH (PRESIDENT) |
| Authorized Official Telephone | 7088685020 |
| Authorized Official Credential | RPH |
| 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 |
054010011 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1459800 | 01 | |
| IL | 367728439001 | 05 |
| Other Name | Type Code |
|---|---|
| PETERSONS PRESCRIPTION PHARMACY | Doing Business As Name - Organization |
| Street Address |
715 LAKE ST |
| City | OAK PARK |
| State | IL |
| Zip Code | 60301-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568427888 | Stephen Schlesinger | Psychologist | 715 Lake St, Suite 806, Oak Park, IL 60301-1422 | 2006-04-19 |
| 1326686171 | Sofia Ana Rowan-martin | Counselor | 715 Lake St, Oak Park, IL 60301-1422 | 2019-12-11 |
| 1699317297 | Erica Patricia Negrete | Social Worker | 715 Lake St, Oak Park, IL 60301-1422 | 2019-10-15 |
| 1073163465 | Dialyze Direct Il LLC | Clinic/Center | 715 Lake St, Oak Park, IL 60301-1422 | 2019-09-17 |
| 1295389955 | Alison Possehl | Social Worker | 715 Lake St, Oak Park, IL 60301-1422 | 2019-07-30 |
| 1952881831 | Karen Escobar | Social Worker | 715 Lake St, Oak Park, IL 60301-1422 | 2018-08-20 |
| 1659870798 | Crystal Rose Johnson | Psychologist | 715 Lake St, Oak Park, IL 60301-1422 | 2018-02-05 |
| 1871049635 | Tara Dethmers | Advanced Practice Midwife | 715 Lake St, #273, Oak Park, IL 60301-1422 | 2016-08-31 |
| 1902359938 | Vince Murphy & Associates, P.C. | Social Worker | 715 Lake St, Suite 510, Oak Park, IL 60301-1422 | 2016-07-26 |
| 1356799514 | Tara Beyer | Counselor | 715 Lake St, Suite 800, Oak Park, IL 60301-1422 | 2016-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457982332 | Heather Lea Corwin | Counselor | Blackbird Behavioral Health, 715 Lake Street, 4th Floor, Oak Park, IL 60301 | 2020-01-30 |
| 1194244400 | Kristin Burns Mind and Body | Clinic/Center | 715 Lake St Ste 703, Oak Park, IL 60301 | 2017-09-18 |
| 1538686357 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1129 Lake St., Oak Park, IL 60301 | 2017-08-23 |
| 1851835888 | Wanda Secthecia Presley | Nurse's Aide | 1140 South Lake Street, Oak Park, IL 60301 | 2016-12-09 |
| 1477914323 | Naomi Elise Heinz | Occupational Therapist | 820 North Boulevard, Kids Unlimited Therapy Services, LLC, Oak Park, IL 60301 | 2016-03-18 |
| 1316339518 | Christina Shrader | Counselor | 137 N Oak Park Ave Ste 123, Oak Park, IL 60301 | 2015-02-24 |
| 1356755334 | Grief Recovery Group, Inc | Social Worker | 1010 Lake Street, Suite 620, Oak Park, IL 60301 | 2014-06-17 |
| 1700137239 | Christine Marie Hare | Nurse Practitioner | 1100 Lake St Ste 120, Oak Park, IL 60301 | 2012-09-24 |
| 1427334622 | Ina N. Owens | Social Worker | 137 N. Oak Park Ave, Oak Park, IL 60301 | 2011-11-01 |
| 1265720130 | Debora S Crowley | Occupational Therapist | 820 North Blvd., Oak Park, IL 60301 | 2011-07-13 |
| Find all providers in zip 60301 | ||||
| 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 |
|---|---|---|---|---|
| 1477183804 | Oak Park Rx LLC | Pharmacy | 24651 Coolidge Hwy, Oak Park, MI 48237-1449 | 2020-01-24 |
| 1669011524 | Purepoint Pharmacy LLC | Pharmacy | 15075 Lincoln St Apt 110, Oak Park, MI 48237-1289 | 2019-12-24 |
| 1962051102 | Apexrx LLC | Pharmacy | 25290 Greenfield Rd, Oak Park, MI 48237-4032 | 2019-09-10 |
| 1558853770 | Safeway Pharmacy LLC | Pharmacy | 25222 Greenfield Rd, Oak Park, MI 48237-4032 | 2018-06-04 |
| 1225412786 | Praxis Specialty Pharmacy, LLC | Pharmacy | 455 N Harlem Ave, Lower Level, Oak Park, IL 60301-2020 | 2015-07-15 |
| 1982716825 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 23001 Coolidge Hwy, Oak Park, MI 48237-2071 | 2006-08-31 |
| 1104938190 | Detroit Hope Pharmacy Inc | Pharmacy | 24695 Coolidge Hwy, Oak Park, MI 48237-1449 | 2006-08-31 |
| 1467563742 | Lincoln Drugs Inc | Pharmacy | 25901 Coolidge Hwy, Oak Park, MI 48237-1108 | 2006-08-31 |
| 1598262420 | Lincoln Rx Inc | Pharmacy | 25901 Coolidge Hwy, Oak Park, MI 48237-1108 | 2018-04-08 |
| 1114278926 | Beacon Professional Pharmacy, Inc | Pharmacy | 23350 Greenfield Rd, Oak Park, MI 48237-2496 | 2012-09-20 |
| Find all providers in OAK PARK | ||||
Please comment or provide details below to improve the information on PETERSONS PERSCRIPTION PHARMACY INC.
| 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.