ILLINOIS DEPARTMENT OF HUMAN (NPI# 1528111424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528111424 |
| Entity Type | Organization |
| Organization Name | ILLINOIS DEPARTMENT OF HUMAN |
| Other Organization Name | SHAPIRO DEVELOPMENT CENTER PHARMACY |
| Practice Address |
100 E Jeffery St Kankakee IL 60901-5018 |
| Practice Telephone | 8159398272 |
| Practice Fax Number | 8159398274 |
| Mailing Telephone | 8159398272 |
| Mailing Fax Number | 8159398274 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2017-05-01 |
| Authorized Official Name | SCOTT MCCONAUGHY (PHARMACY MANAGER) |
| Authorized Official Telephone | 8159398272 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
054.020222 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2023336 | 01 |
| Other Name | Type Code |
|---|---|
| SHAPIRO DEVELOPMENT CENTER PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255462156 | Illinois Department of Human | Pharmacy | 901 Southwind Dr, Springfield, IL 62703-5125 | 2007-03-09 |
| 1457404667 | Illinois Department of Human | Pharmacy | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-01-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ILLINOIS DEPARTMENT OF HUMAN SERVICES | 401 S Clinton St, Chicago, IL 60607-3800 |
| Street Address |
100 E JEFFERY ST |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609947407 | Catalina Fernald | Psychiatry & Neurology | 100 E Jeffery St, Center Building, Dept of Behavioral Health, 3rd Floor, Kankakee, IL 60901-5018 | 2006-11-13 |
| 1508984667 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-27 |
| 1306964937 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1891813440 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1356468961 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1669599270 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1205954849 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1801914445 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1891812582 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| 1609993302 | Shapiro Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Jeffery St, Kankakee, IL 60901-5018 | 2007-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1043723943 | Oakside Corporation | Pharmacy | 350 N Wall St, Kankakee, IL 60901-2901 | 2017-11-14 |
| 1740323096 | Oakside Corporation | Pharmacy | 400 N Wall St, Suite One, Kankakee, IL 60901-2940 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912512989 | Millenium Pharmacy Ltd | Pharmacy | 10604 Southwest Hwy Ste 102, Chicago Ridge, IL 60415-2704 | 2020-09-15 |
| 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 |
| 1679039358 | Remedi Seniorcare of Chicago, LLC | Pharmacy | 3600 Lacey Road, Suite 500, Downers Grove, IL 60515 | 2019-02-18 |
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1538672449 | Wear Ltc | Pharmacy | 527 N Madison St Ste B, Carthage, IL 62321-1034 | 2017-11-14 |
| 1124546031 | Symbria Rx Services, LLC. | Pharmacy | 3200 Grant St Rm 41, Evanston, IL 60201-1903 | 2017-08-31 |
| 1699146720 | Pharmblue Illinois LLC | Pharmacy | 2960 Chartres St Ste 100, La Salle, IL 61301-1097 | 2015-10-15 |
| 1194144691 | Lifemed Illinois, LLC | Pharmacy | 881 Il Route 83, Bensenville, IL 60106-1219 | 2014-04-11 |
| 1205250412 | Becks Long Term Care Pharmacy Inc | Pharmacy | 1413 Locust Street, Eldorado, IL 62930 | 2014-02-07 |
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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.