NORTHSHORE UNIVERSITY HEALTHSYSTEM (NPI# 1073563946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073563946 |
| Entity Type | Organization |
| Organization Name | NORTHSHORE UNIVERSITY HEALTHSYSTEM |
| Other Organization Name | LIBERTYVILLE PHARMACY |
| Practice Address |
1451 Peterson Rd Libertyville IL 60048-1001 |
| Practice Telephone | 8475738067 |
| Practice Fax Number | 8475738746 |
| Mailing Telephone | 8476575799 |
| Mailing Fax Number | 8476571870 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-01-29 |
| Authorized Official Name | STANLEY S KENT (ASSISTANT VICE PRESIDENT PHARMACY) |
| Authorized Official Telephone | 8475702202 |
| Authorized Official Credential | MS RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054014166 | IL | Suppliers |
| Other Name | Type Code |
|---|---|
| Libertyville Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942561469 | Northshore University Healthsystem | Pharmacy | 757 Park Ave W Rm 1851, Highland Park, IL 60035-2556 | 2012-05-31 |
| 1891052510 | Northshore University Healthsystem | Pharmacy | 2180 Pfingsten Rd Ste 1008, Glenview, IL 60026-1339 | 2012-04-19 |
| 1467723759 | Northshore University Healthsystem | Pharmacy | 9650 Gross Point Rd # 1901, Skokie, IL 60076-1214 | 2012-01-19 |
| 1609817220 | Northshore University Healthsystem | General Acute Care Hospital | 777 Park Ave W, Highland Park, IL 60035-2433 | 2006-06-08 |
| 1437106077 | Northshore University Healthsystem | Home Health | 4901 Searle Pkwy, Suite 160, Skokie, IL 60077-5313 | 2006-05-28 |
| 1003173501 | Northshore University Healthsystem | Durable Medical Equipment & Medical Supplies | 680 N Lake Shore Dr, Suite 924, Chicago, IL 60611-4546 | 2012-04-20 |
| 1962768796 | Northshore University Healthsystem | Durable Medical Equipment & Medical Supplies | 2501 Compass Rd, Suite 2501, Glenview, IL 60026-8000 | 2012-04-05 |
| 1689944431 | Northshore University Healthsystem | Clinic/Center | 2650 Ridge Ave, Evanston, IL 60201-1718 | 2012-01-11 |
| 1497086771 | Northshore University Healthsystem | Clinic/Center | 9811 Woods Dr, H-190, Skokie, IL 60077-4470 | 2010-01-26 |
| 1316177413 | Northshore University Healthsystem | General Acute Care Hospital | 2650 Ridge Ave, Evanston, IL 60201-1718 | 2009-07-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | 1301 Central St, Evanston, IL 60201-1613 |
| System for Award Management (SAM) Entities | NORTHSHORE UNIVERSITY HEALTHSYSTEM RESEARCH INSTITUTE | 1001 University Place Suite 100, Evanston, IL 60201-3137 |
| Street Address |
1451 PETERSON RD |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861434581 | Wayne M Vivirito | Pharmacist | 1451 Peterson Rd, Libertyville, IL 60048-1001 | 2006-06-11 |
| 1962621391 | Amy Ann Ross | Pharmacist | 1451 Peterson Rd, Libertyville, IL 60048-1001 | 2007-04-24 |
| 1952528887 | Tina Kolovos | Pharmacist | 1451 Peterson Rd, Libertyville, IL 60048-1001 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| 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 |
|---|---|---|---|---|
| 1619536240 | Carepartners Pharmacy LLC | Pharmacy | 326 Peterson Rd, Libertyville, IL 60048-1008 | 2019-06-07 |
| 1093952046 | Pharmacy Healthcare Solutions, Ltd. | Pharmacy | 600 N Us Highway 45, East Bldg, Rm# 06z, Libertyville, IL 60048-1286 | 2009-01-13 |
| 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 | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on NORTHSHORE UNIVERSITY HEALTHSYSTEM.
| 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.