HIGHLAND PARK CVS, L.L.C. (NPI# 1376579623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376579623 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C. |
| Other Organization Name | SCHNUCKS PHARMACY |
| Practice Address |
109 N Mattis Ave Champaign IL 61821-3059 |
| Mailing Address |
1 Cvs Dr # 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2173518497 |
| Practice Fax Number | 2173518056 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | SUSAN F COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
Nursing Service Providers | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 054001003 | IL | Suppliers |
| N | 333600000X | Pharmacy | 054001003 | IL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1459634 | 01 | |
| IL | 430726776707 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #18078 | Doing Business As Name - Organization |
| SCHNUCKS PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260552 | Highland Park Cvs, L.L.C. | Registered Nurse | 800 Carlyle Ave, Belleville, IL 62221-5509 | 2018-09-27 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1326598319 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1346 E 53rd St., Chicago, IL 60615 | 2016-10-13 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1871047423 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1500 Lincoln Highway, St Charles, IL 60734-3579 | 2016-08-12 |
| 1134576804 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 2000 S Naperville Rd, Wheaton, IL 60189-8153 | 2016-05-23 |
| 1235503517 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3900 W Elm St, Mchenry, IL 60050-4362 | 2015-11-24 |
| 1255698189 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 2239 E Cook St Ste 101, Springfield, IL 62703-1944 | 2012-04-17 |
| 1144540725 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 100 S Fell Ave, Suite 103, Normal, IL 61761 | 2010-06-07 |
| 1396062824 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 10420 Grand Ave, Franklin Park, IL 60131-2209 | 2010-04-23 |
| Street Address |
109 N MATTIS AVE |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-3059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568948743 | Skylar Reid Bolduc | Pharmacist | 109 N Mattis Ave, Champaign, IL 61821-3059 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| 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 |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1316331630 | Walgreen Co | Pharmacy | 407 E Green St, Champaign, IL 61820-5610 | 2015-03-25 |
| 1437409851 | Niemann Foods Inc | Pharmacy | 2901 W Kirby Ave, Champaign, IL 61821-5301 | 2012-09-13 |
| 1134139090 | Walgreen Co. | Pharmacy | 1509 S Neil St, Champaign, IL 61820-6531 | 2006-08-09 |
| 1922013036 | Walgreen Co | Pharmacy | 841 Bloomington Rd, Champaign, IL 61820-2101 | 2006-07-29 |
| 1689689705 | Walgreen Co | Pharmacy | 1713 W Springfield Ave, Champaign, IL 61821-3011 | 2006-07-29 |
| 1861414674 | Highland Park Cvs LLC | Pharmacy | 2102 N Prospect Ave, Champaign, IL 61822-1231 | 2006-07-24 |
| 1285675157 | Highland Park Cvs LLC | Pharmacy | 107 W Green St, Champaign, IL 61820-5213 | 2006-06-09 |
| 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 |
| 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 |
| 1518581784 | Biovita Pharmacy Inc. | Pharmacy | 955 W 75th St, Naperville, IL 60565-6189 | 2020-06-03 |
| 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.