HIGHLAND PARK CVS, L.L.C. (NPI# 1508087719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508087719 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK CVS, L.L.C. |
| Other Organization Name | CVS PHARMACY # 03790 |
| Practice Address |
1305 Randall Road Crystal Lake IL 60014 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 8153560386 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-10-08 |
| Authorized Official Name | MR. THOMAS RYAN (CHAIRMAN, PRESIDENT, AND CEO) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE RR | P00754411 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy # 03790 | 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 |
1305 RANDALL ROAD |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992736052 | Kmart Stores of Illinois LLC | Pharmacy | 6000 Northwest Hwy, Crystal Lake, IL 60014-8062 | 2006-07-06 |
| 1043252570 | Comfort Care Pharmacy PC | Pharmacy | 1095 Pingree Rd, Crystal Lake, IL 60014-1725 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702549 | Aster Pharmacy LLC | Pharmacy | 9213 Waukegan Rd, Morton Grove, IL 60053-2102 | 2020-05-27 |
| 1568083301 | Pointcore, Inc. | Pharmacy | 1800 N Knoxville Ave Ste G, Peoria, IL 61603-3028 | 2020-05-04 |
| 1336768001 | Mhg Pharmacy Services, LLC | Pharmacy | 2923 N California Ave Ste 240, Chicago, IL 60618-7702 | 2020-04-13 |
| 1184258824 | Metropolitian Austin Outpatient Pharmacy LLC | Pharmacy | 645 S Central Ave Ste 1, Chicago, IL 60644-5059 | 2020-03-02 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1568093615 | Carefirst Pharmacy, Inc. | Pharmacy | 2253 N Cicero Ave, Chicago, IL 60639-3327 | 2020-01-28 |
| 1720624521 | Affinity Pharmacy Care LLC | Pharmacy | 285 W Loop Rd Ste 1, Wheaton, IL 60189-2036 | 2019-11-27 |
| 1104462126 | Loyola University Medical Center | Pharmacy | 2160 S 1st Ave Rm 150-1610, Maywood, IL 60153-3328 | 2019-11-25 |
| 1346886512 | Value Plus Pharmacy LLC | Pharmacy | 457 W Liberty St, Wauconda, IL 60084-2452 | 2019-11-22 |
| 1841833100 | April M Bailey | Pharmacy | 1019 Oakcrest Dr, Rantoul, IL 61866-1118 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on HIGHLAND PARK CVS, L.L.C..
| 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.