MARIANOS PHARMACY #8540
NPI 1669915005
Pharmacy - Community/Retail Pharmacy in Bloomingdale, IL

NPI Status: Active since December 01, 2016

Contact Information

144 S GARY AVE
BLOOMINGDALE, IL
ZIP 60108
Phone: (630) 671-9138
Fax: (630) 671-9235

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 14D2175019
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 11-13-2025

About MARIANOS PHARMACY #8540

This page provides the complete NPI Profile along with additional information for Marianos Pharmacy #8540, a provider established in Bloomingdale, Illinois operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1669915005 assigned on December 2016. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Marianos Pharmacy #8540. The authorized official of this NPI record is William Dowling (Vice President)

NPI
1669915005
Provider Legal Name
ROUNDYS SUPERMARKETS INC
Other Organization Name
MARIANOS PHARMACY #8540
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
144 S GARY AVE BLOOMINGDALE, IL 60108
Location Phone
(630) 671-9138
Location Fax
(630) 671-9235
Mailing Address
PO BOX 473 MILWAUKEE, WI 53201
Mailing Phone
(414) 231-5000
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-01-2016
Last Update Date
12-01-2016
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Marianos Pharmacy #8540 is a medicare supplier with PTAN 20563379 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Silver - EPO
  • Clear Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete VALUE Gold - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Gold VALUE - HMO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clarity Silver - HMO
  • Clarity VALUE Silver - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - EPO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - EPO
  • Elite Gold + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Standard Silver + Vision + Adult Dental - PPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • ConnectPlus $0 Gold - PPO
  • ConnectPlus $0 Silver - PPO
  • ConnectPlus $10,600 HSA Eligible HDHP - PPO
  • ConnectPlus $1800 - PPO
  • ConnectPlus $4500 - PPO
  • ConnectPlus $6500 HSA Eligible HDHP - PPO
  • ConnectPlus $7500 HSA Eligible HDHP - PPO
  • ConnectPlus MyWeighForward $2000 - PPO
  • ConnectPlus MyWeighForward $6000 - PPO
  • ConnectPlus Standard $2000 - PPO
  • ConnectPlus Standard $6000 - PPO
  • ConnectPlus Standard $7500 HSA Eligible HDHP - PPO
  • DirectConnect $0 Gold - HMO
  • DirectConnect $0 Silver - HMO
  • DirectConnect $1800 - HMO
  • DirectConnect $4500 - HMO
  • DirectConnect $6500 HSA Eligible HDHP - HMO
  • DirectConnect $7500 HSA Eligible HDHP - HMO
  • DirectConnect MyWeighForward $2000 - HMO
  • DirectConnect MyWeighForward $6000 - HMO
  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • AvMed Entrust Silver 350 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver 550 (2026) - HMO
  • AvMed Entrust Silver 550 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver Standard (2026) - HMO
  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • Blue Cross Select Gold - PPO
  • Blue Cross Select Silver - PPO
  • Blue HSA Bronze - PPO
  • Blue Protect - PPO
  • Blue Saver Bronze - PPO
  • Blue Saver Silver EPO - EPO
  • Blue Standardized Bronze - PPO
  • Blue Standardized Gold - PPO
  • Blue Standardized Silver - PPO
  • Blue Standardized Silver EPO - EPO
  • Blue Standardized Statewide Silver EPO - EPO
  • Blue Statewide Silver EPO - EPO
  • Blue Value Gold - PPO
  • Blue Value Silver - PPO
  • Blue Access Gold for Business - PPO
  • Blue Choice Platinum for Business - PPO
  • Blue HSA Silver for Business - PPO
  • Blue Saver Bronze for Business - PPO
  • Blue Saver Gold for Business - PPO
  • Blue Secure Gold for Business - PPO
  • Blue KC Catastrophic BlueSelect EPO - EPO
  • Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
  • Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
  • Blue KC Community Silver Preferred-Care Blue EPO - EPO
  • Blue KC First Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Simply Blue Bronze with Spira Care Blue Metro EPO - EPO
  • Blue KC Simply Blue Gold with Spira Care Blue Metro EPO - EPO
  • Blue KC Simply Blue Silver with Spira Care Blue Metro EPO - EPO
  • Blue KC Standard Bronze BlueSelect EPO - EPO
  • Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Standard Gold BlueSelect EPO - EPO
  • Blue KC Standard Gold Preferred-Care Blue EPO - EPO
  • Blue KC Standard Silver BlueSelect EPO - EPO
  • Blue KC Standard Silver Preferred-Care Blue EPO - EPO
  • Blue Focus Bronze POS? 205 - POS
  • Blue Focus Bronze POS? 705 - POS
  • Blue Focus Bronze POS? Standard - POS
  • Blue Focus Gold POS? 207 - POS
  • Blue Focus Gold POS? 902 - POS
  • Blue Focus Gold POS? Standard - POS
  • Blue Focus Silver POS? 206 - POS
  • Blue Focus Silver POS? 903 - POS
  • Blue Focus Silver POS? Standard - POS
  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue - EPO
  • HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze 6000 Blueprint Health w/ Adult Vision - EPO
  • HeartlandBlue Bronze 6000 Premier Select BlueChoice w/ Adult Vision - EPO
  • HeartlandBlue Bronze HSA 6500 Blueprint Health - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice - EPO
  • HeartlandBlue Bronze Standard 7500 Blueprint Health - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue - EPO
  • HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO - PPO
  • HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice - EPO
  • HeartlandBlue Gold $0 PCP Visit 1500 Blueprint Health - EPO
  • HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue - EPO
  • HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue PPO - PPO
  • HeartlandBlue Gold $0 PCP Visit 1500 Premier Select BlueChoice - EPO
  • HeartlandBlue Gold 1000 Blueprint Health w/ Adult Vision - EPO
  • HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision - EPO
  • HeartlandBlue Gold 1000 NEtwork Blue w/ Adult Vision PPO - PPO
  • HeartlandBlue Gold 1000 Premier Select BlueChoice w/ Adult Vision - EPO
  • Blue Advantage Bronze PPO? 202 - PPO
  • Blue Advantage Bronze PPO? 203 - PPO
  • Blue Advantage Bronze PPO? Standard - PPO
  • Blue Advantage Gold PPO? 309 - PPO
  • Blue Advantage Gold PPO? 604 - PPO
  • Blue Advantage Gold PPO? Standard - PPO
  • Blue Advantage Silver PPO? 204 - PPO
  • Blue Advantage Silver PPO? 501 - PPO
  • Blue Advantage Silver PPO? Standard - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? Standard - PPO
  • MyBlue Bronze HMO? 902 - HMO
  • MyBlue Bronze HMO? 904 - HMO
  • MyBlue Bronze HMO? Standard - HMO
  • MyBlue Gold HMO? 704 - HMO
  • MyBlue Gold HMO? 804 - HMO
  • MyBlue Gold HMO? Standard - HMO
  • MyBlue Silver HMO? 705 - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
  • BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
  • BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
  • BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
  • BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
  • DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
  • BlueSelect Bronze Basic - PPO
  • BlueSelect Bronze Core - PPO
  • BlueSelect Expanded Bronze Standard without Kid's Dental - PPO
  • BlueSelect Gold Core - PPO
  • BlueSelect Gold HealthPlus - PPO
  • BlueSelect Gold Standard without Kid's Dental - PPO
  • BlueSelect Silver Classic - PPO
  • BlueSelect Silver Classic without Kid's Dental - PPO
  • BlueSelect Silver HealthPlus - PPO
  • BlueSelect Silver HealthPlus without Kid's Dental - PPO
  • BlueSelect Silver Standard without Kid's Dental - PPO
  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 (Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
  • BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-05 (Rewards) - POS
  • BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-18 (Rewards) - POS
  • BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
  • BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS
  • Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
  • Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
  • Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
  • Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
  • Better Together HMO Platinum No Ded/3300 MOOP - HMO
  • Better Together HMO Platinum No Ded/5200 MOOP - HMO
  • Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
  • Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Partners HMO Gold 2000 Ded/8200 MOOP - HMO
  • Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • NE WI Select $3,150 Plus Silver - PPO
  • NE WI Select $3,800 HSA Silver - PPO
  • NE WI Select $6,000 Standard Silver - PPO
  • NE WI Select $6,800 Plus Bronze HSA - PPO
  • NE WI Select $7,500 Standard Bronze HSA - PPO
  • NE WI Select $8,400 HSA Bronze - PPO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Select by Medica Bronze $0 Copay PCP Visits - EPO
  • Select by Medica Bronze Share - EPO
  • Select by Medica Expanded Bronze Standard - EPO
  • Select by Medica Gold $0 Copay PCP Visits - EPO
  • Select by Medica Gold Share - EPO
  • Select by Medica Gold Standard - EPO
  • Select by Medica Silver $0 Copay PCP Visits - EPO
  • Select by Medica Silver Share - EPO
  • Select by Medica Silver Standard - EPO
  • Bronze $8,300 w/ Adult Dental ON-EX - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1,000 w/ Adult Dental ON-EX - HMO
  • Gold $1,000 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5,000 w/ Adult Dental ON-EX - HMO
  • Silver $5,000 w/ Virtual & Wellness ON-EX - HMO
  • Silver $5,800 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $10,600 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,500 - PPO
  • Sanford Individual Simplicity $7,200 HSA Qualified - PPO
  • Sanford Individual Simplicity Standardized $2,000 - PPO
  • Sanford Individual Simplicity Standardized $6,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • Sanford Individual TRUE $1,750 - HMO
  • Sanford Individual TRUE $10,600 - HMO
  • Sanford Individual TRUE $3,500 - HMO
  • Sanford Individual TRUE $4,750 - HMO
  • Sanford Individual TRUE $6,500 - HMO
  • Sanford Individual TRUE $7,200 HSA Qualified - HMO
  • Sanford Individual TRUE Standardized $2,000 - HMO
  • Sanford Individual TRUE Standardized $6,000 - HMO
  • Sanford Individual TRUE Standardized $7,500 - HMO
  • SummaCare Bronze 10600 with 3 Free PCP Visits - HMO
  • SummaCare Bronze 10600 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Bronze 8000 - HMO
  • SummaCare Bronze 8000 with Adult Vision Exam - HMO
  • SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Gold 2000 with 3 Free PCP Visits - HMO
  • SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
  • SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision - HMO
  • SummaCare Silver 7000 with 3 Free PCP Visits - HMO
  • SummaCare Standard Bronze - HMO
  • SummaCare Standard Bronze with Adult Vision - HMO
  • SummaCare Standard Gold - HMO
  • SummaCare Standard Gold with Adult Vision - HMO
  • SummaCare Standard Silver - HMO
  • SummaCare Standard Silver with Adult Vision - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus (No Referrals) - HMO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
  • UHC Bronze Essential - HMO
  • UHC Bronze Essential- - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

WILLIAM DOWLING

Authorized Official Title
VICE PRESIDENT
Authorized Official Phone
(414) 231-5000

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 36 times for 36 patients

Adm sarscv2 30mcg trs-sucr b

This service involves the administration of a 30mcg dose of the SARS-CoV-2 vaccine, which helps protect against COVID-19. The 'trs-sucr b' indicates it's stabilized with sugars for effectiveness. It's a crucial step in maintaining your health during the pandemic.

This service was performed 25 times for 25 patients

Administration of influenza virus vaccine

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.

This service was performed 78 times for 77 patients

Fee covid-19 vac 13 res

The "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.

This service was performed 25 times for 25 patients

Fee covid-19 vac 14 res

The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.

This service was performed 21 times for 21 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 73 times for 72 patients

Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count

This service provides a FDA-approved COVID-19 test kit for personal use. The test is self-administered and self-collected, meaning you conduct the test yourself. The kit contains all necessary items for one test. Follow the instructions carefully to ensure accurate results.

This service was performed 348 times for 39 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20563379
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2175019
Facility Type
Pharmacy
Certificate Effective Date
November 14, 2023
Certificate Expiration Date
November 13, 2025
Laboratory Director
STACY DOYLE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Marianos Pharmacy #8540 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669915005, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
1
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 9 → 18 → 9 5 → 10 → 1 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 1 + 8 + 1 + 1 + 0 + 0 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1669915005.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Pharmacist
144 S GARY AVE
BLOOMINGDALE, IL 60108
Pharmacist
144 S GARY AVE
BLOOMINGDALE, IL 60108
Pharmacist
144 S GARY AVE
BLOOMINGDALE, IL 60108
Pharmacy (Community/Retail Pharmacy)
144 S GARY AVE
BLOOMINGDALE, IL 60108

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669915005, enumerated as an "organization" on December 01, 2016.

The provider is located at 144 S GARY AVE BLOOMINGDALE, IL 60108 and the phone number is (630) 671-9138.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.