ILLINI CLINIC PHARMACY INC (NPI# 1356561039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356561039 |
| Entity Type | Organization |
| Organization Name | ILLINI CLINIC PHARMACY INC |
| Practice Address |
855 Illini Dr Suite 200 Silvis IL 61282-2907 |
| Practice Telephone | 3097927002 |
| Practice Fax Number | 3097927003 |
| Mailing Telephone | 3097927002 |
| Mailing Fax Number | 3097927003 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | MR. JEFFREY R MERIDETH (PRESIDENT) |
| Authorized Official Telephone | 3097927002 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054013807 | IL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871110254 | Illini Clinic Pharmacy Inc | Pharmacy | 103 N Prospect St, Cambridge, IL 61238-1148 | 2020-07-01 |
| 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 |
| Street Address |
855 ILLINI DR SUITE 200 |
| City | SILVIS |
| State | IL |
| Zip Code | 61282-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912005 | Michael A Cottone | Family Medicine | 855 Illini Dr, Ste 300, Silvis, IL 61282-2904 | 2005-06-16 |
| 1205202074 | Shannon Vanzummeren | Nurse Practitioner | 855 Illini Dr, Suite 304, Silvis, IL 61282-2907 | 2015-08-17 |
| 1801182753 | Genesis Health System | Psychologist | 855 Illini Dr, Suite 202, Silvis, IL 61282-2907 | 2011-06-20 |
| 1669672325 | Michael A Burchett | Surgery | 855 Illini Dr, Suite 304, Silvis, IL 61282-2907 | 2007-07-20 |
| 1093912818 | Andrew F Philip | Surgery | 855 Illini Dr, Suite 304, Silvis, IL 61282-2907 | 2007-06-27 |
| 1598961658 | Magdy Mostafa | Internal Medicine | 855 Illini Dr, Ste 305, Silvis, IL 61282-2907 | 2007-06-26 |
| 1093893919 | Roxanne M Schmertmann | Nurse Practitioner | 855 Illini Dr, Ste 408, Silvis, IL 61282-2907 | 2006-11-01 |
| 1154439404 | Genesis Health System | Obstetrics & Gynecology | 855 Illini Dr, Suite 408, Silvis, IL 61282-2907 | 2006-08-28 |
| 1063520310 | Genesis Health System | Pediatrics | 855 Illini Dr, Suite 304, Silvis, IL 61282-2907 | 2006-08-28 |
| 1427164706 | Genesis Health System | Family Medicine | 855 Illini Dr, Ste 300, Silvis, IL 61282-2907 | 2006-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172605 | Phyllis Cunningham | Technician | 603 2nd Ave C, Silvis, IL 61282 | 2019-09-07 |
| 1710369400 | Krystle Lee Hergert | Dietitian, Registered | 2001 5th Street, Silvis, IL 61282 | 2015-06-18 |
| 1558549469 | Bobb Chiropractic Center P.C. | Chiropractor | 813 1st Avenue, Silvis, IL 61282 | 2008-02-01 |
| 1952509846 | Jennifer Marie Jensen | Pharmacist | 1601 18th St, Silvis, IL 61282 | 2007-07-03 |
| 1871516781 | Joseph R Yates | Emergency Medicine | 801 Illini Drive, Silvis, IL 61282 | 2006-07-25 |
| 1376581447 | Holly S Wilkinson | Physical Therapist | 902 Illini Drive, Silvis, IL 61282 | 2006-06-02 |
| 1831145507 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 1312 John Deere Expy, Silvis, IL 61282 | 2006-05-25 |
| 1194326017 | Paul Garner | Pharmacist | 2001 5th St, Silvis, IL 61282 | 2020-11-06 |
| 1366043291 | Karen Marie Garner | Pharmacist | 2001 5th Street, Silvis, IL 61282 | 2020-11-06 |
| 1659865848 | Njl Chiropractic | Clinic/Center | 813 1st Ave, Silvis, IL 61282 | 2018-06-20 |
| Find all providers in zip 61282 | ||||
| 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 |
|---|---|---|---|---|
| 1013058262 | Cosgrave Pharmacy Inc | Pharmacy | 908 1st Ave, Silvis, IL 61282-1047 | 2007-02-09 |
| 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 |
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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.