WELLCARE PHARMACY LLC (NPI# 1760927057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760927057 |
| Entity Type | Organization |
| Organization Name | WELLCARE PHARMACY LLC |
| Practice Address |
9760 S Kedzie Ave Evergreen Park IL 60805-3109 |
| Practice Telephone | 7089305927 |
| Practice Fax Number | 7089305935 |
| Mailing Telephone | 7089305927 |
| Mailing Fax Number | 7089305935 |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2017-03-23 |
| Authorized Official Name | HANI ABDALLAH (OWNER, AO, PHCY MANAGER, PIC) |
| Authorized Official Telephone | 7083077839 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
054020144 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2167135 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295296390 | Wellcare Pharmacy LLC | Pharmacy | 17530 Hawthorne Blvd, Torrance, CA 90504-3110 | 2019-03-29 |
| 1417290008 | Wellcare Pharmacy LLC | Pharmacy | 4200 South Fwy Ste 26, Fort Worth, TX 76115-1400 | 2013-04-01 |
| Street Address |
9760 S KEDZIE AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306836663 | Thomas Joseph | Internal Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2005-10-26 |
| 1518445543 | Christine Najarian | Physician Assistant | 9760 S Kedzie Ave, Evergreen Park, IL 60805-3109 | 2018-08-01 |
| 1457894768 | Rachel Brucas | Physician Assistant | 9760 S Kedzie Ave, Evergreen Park, IL 60805-3109 | 2016-11-18 |
| 1841587334 | Kristina Ann Johnson | Family Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2011-07-05 |
| 1033438460 | Health Solutions At Home Inc | Home Health | 9760 S Kedzie Ave, Suite 10b, Evergreen Park, IL 60805-3109 | 2010-05-25 |
| 1487987707 | Alicia Lopez | Pediatrics | 9760 S Kedzie Ave, Suite 11, Evergreen Park, IL 60805-3109 | 2009-09-18 |
| 1073746046 | George Thomas | Family Medicine | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2009-08-25 |
| 1447449616 | Evergreen Care Center Ltd | General Practice | 9760 S Kedzie Ave, Suite 3, Evergreen Park, IL 60805-3109 | 2007-10-23 |
| 1891984068 | Park Primary Care Ltd | General Practice | 9760 S Kedzie Ave, Suite 2, Evergreen Park, IL 60805-3109 | 2007-10-23 |
| 1740488154 | Thomas Anthony Koludrovic | Dentist | 9760 S Kedzie Ave, Suite 4, Evergreen Park, IL 60805 | 2007-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| 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 |
|---|---|---|---|---|
| 1942412119 | G & B Drugs | Pharmacy | 2850 W. 95st, Suite 100, Evergreen Park, IL 60805-2735 | 2007-05-03 |
| 1366840662 | Roundys Supermarkets Inc | Pharmacy | 2559 W 95th St, Evergreen Park, IL 60805 | 2014-12-18 |
| 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 | EVERGREEN PARK |
| Zip Code | 60805 |
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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.