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CVS PHARMACY #17536
NPI 1124265509
Pharmacy in Hillside, IL

Active since January 07, 2009CLIA 14D2282200 · Waiver
130 S MANNHEIM RD, HILLSIDE, IL 60162(708) 375-5072(708) 375-5082 Get Directions Write a Review

NPPES record last updated: September 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 23, 2016, Aug 25, 2016, Jan 19, 2016 (3 updates tracked since 2016).

About Cvs Pharmacy #17536 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #17536 (NPI 1124265509) is a healthcare organization registered as a pharmacy in Hillside, Illinois and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through May 17, 2027 and lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1124265509
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHIGHLAND PARK CVS LLC
Location Address130 S MANNHEIM RDHillside, IL 60162-1821
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Phone(708) 375-5072
Fax(708) 375-5082
Organization SubpartNo
Authorized OfficialSusan ColbertSr. Director, Payer Relations · (401) 770-2751
Enumeration DateJanuary 7, 2009
Last NPPES UpdateSeptember 23, 20163 updates tracked since enumeration
✔ NPI 1124265509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X · License 054.019750 (IL)
130 S MANNHEIM RD, Hillside, IL 60162
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Other Names 1

Doing Business AsCvs Pharmacy #17536

Other Identifiers 2

Other2118412Pk
Medicare NSC4723660322

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2282200

Cvs/Pharmacy #02827 Highland Park CVS LLC · Hillside, IL
Active · expires May 17, 2027
CLIA Number14D2282200
Laboratory TypePharmacy
Certificate Effective DateMay 18, 2025
Certificate Expiration DateMay 17, 2027
Laboratory DirectorAbdulkader Aldaif
Laboratory Phone(708) 649-3741
Laboratory LocationCvs/Pharmacy #02827 Highland Park CVS LLC600 N Mannheim Rd, Hillside, IL 60162
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
91 services90 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
78 services78 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #17536 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #17536

DMEPOS supplier · Hillside, ILOperated by Highland Park CVS LLC
✔

Accepts Medicare assignment

CVS Pharmacy #17536 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20333027
Medicare Participant SinceJanuary 1, 2023
Supplier Location130 S Mannheim RdHillside, IL 60162
Phone(708) 375-5072
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANJBAR EYECARE CORP
Optometrist
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 547-1893
DIANA RANJBAR
Optometrist
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 547-1984
SVP OPTOMETRY LTD
Optometrist
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 547-1984
RANA VISION INC.
Optometrist
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 547-1893
DR. SAMANTHA MARIE SIEPAK PHARMD
Pharmacist
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 375-5072
LUXOTTICA OF AMERICA INC
Eyewear Supplier
130 S MANNHEIM RD
HILLSIDE, IL 60162
Cook County (708) 547-1893

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Highland Park CVS LLC's NPI number?

The NPI number for Highland Park CVS LLC is 1124265509. It was assigned to this organization in the NPPES registry on January 7, 2009. The provider is doing business as CVS Pharmacy #17536.

Where is Highland Park CVS LLC located?

Highland Park CVS LLC is located at 130 S Mannheim Rd, Hillside, IL 60162. The listed phone number is (708) 375-5072.

What is Highland Park CVS LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Highland Park CVS LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #17536 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Highland Park CVS LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2282200) is associated with this NPI, valid through May 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Highland Park CVS LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 33 other insurers list Highland Park CVS LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Highland Park CVS LLC was last updated on September 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.