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CVS PHARMACY# 04793
NPI 1750606844
Pharmacy in Chicago, IL

Active since March 31, 2010CLIA 14D2282626 · Waiver
1211 W ROOSEVELT RD, CHICAGO, IL 60608(312) 733-0147 Get Directions Write a Review

NPPES record last updated: October 14, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cvs Pharmacy# 04793 NPPES

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

CVS PHARMACY# 04793 (NPI 1750606844) is a healthcare organization registered as a pharmacy in Chicago, Illinois and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through May 23, 2027 and lists Susan F. Colbert, Director Managed Care Contract Adm, as its authorized official.

NPPES Registry Identity

NPI1750606844
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameHIGHLAND PARK CVS, L.L.C.
Location Address1211 W ROOSEVELT RDChicago, IL 60608-1413
Mailing Address1 Cvs Dr, Box 1075-pharmacy EnrollmentsWoonsocket, RI 02895-6146 · (401) 765-1500 · Fax (401) 770-7108
Phone(312) 733-0147
Organization SubpartNo
Authorized OfficialSusan F. ColbertDirector Managed Care Contract Adm · (401) 770-2751
Enumeration DateMarch 31, 2010
Last NPPES UpdateOctober 14, 2014
✔ NPI 1750606844 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
1211 W ROOSEVELT RD, Chicago, IL 60608
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Other Names 1

Doing Business AsCvs Pharmacy# 04793

Other Identifiers 4

Other1484257IL · Ncpdp
Medicare NSC4723660252
Medicaid=========041IL
Medicare PIN215907

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 14D2282626

Cvs/Pharmacy #04793 Highland Park CVS, LLC · Chicago, IL
Active · expires May 23, 2027
CLIA Number14D2282626
Laboratory TypePharmacy
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorCandace Traylor-Holt
Laboratory Phone(312) 733-0147
Laboratory LocationCvs/Pharmacy #04793 Highland Park CVS, LLC1211 W Roosevelt Blvd, Chicago, IL 60608
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.
76 services75 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.
48 services48 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
22 services22 patients

Medical Equipment Supplier Medicare DMEPOS 18

Medicare supplier enrollment and the product categories CVS Pharmacy #11376 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #11376

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

Accepts Medicare assignment

CVS Pharmacy #11376 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)20333729
Medicare Participant SinceJanuary 1, 2023
Supplier Location1034 W Lake StChicago, IL 60607
Phone(312) 705-2004
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
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
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
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 3

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

HYATT KAWADRY PHARMD
Pharmacist
1211 W ROOSEVELT RD
CHICAGO, IL 60608
Cook County (312) 733-0147
DANIEL E JOHNSON PHARMD
Pharmacist
1211 W ROOSEVELT RD
CHICAGO, IL 60608
Cook County (312) 733-0147
DR. CANDACE TRAYLOR-HOLT PHARMD
Pharmacist
1211 W ROOSEVELT RD
CHICAGO, IL 60608
Cook County (312) 733-0147

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, L.L.C.'s NPI number?

The NPI number for Highland Park CVS, L.L.C. is 1750606844. It was assigned to this organization in the NPPES registry on March 31, 2010. The provider is doing business as CVS Pharmacy# 04793.

Where is Highland Park CVS, L.L.C. located?

Highland Park CVS, L.L.C. is located at 1211 W Roosevelt Rd, Chicago, IL 60608. The listed phone number is (312) 733-0147.

What is Highland Park CVS, L.L.C.'s specialty?

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

Does Highland Park CVS, L.L.C. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #11376 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Highland Park CVS, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2282626) is associated with this NPI, valid through May 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Highland Park CVS, L.L.C. 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, L.L.C. 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, L.L.C. was last updated on October 14, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.