Vivent Pharmacy Illinois LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VIVENT PHARMACY ILLINOIS LLC

Practice address

5537 N Broadway St Ste 101
Chicago, IL 60640-1405

Phone

(888) 655-2078

Fax

(872) 813-4226

NPI assigned

May 26, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tony Fields

Title

Chief Pharmacy Officer

Phone

(414) 223-6874

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Tpa Network Incorporated

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1912752569

  Member Of

  NPD member
• Vivent Health Inc

  • Clinic/Center
  • Milwaukee, WI
  • NPI 1982654091

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1003509019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N 6TH ST STE 201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532124006",
            "telephone_number": "800-359-9272",
            "fax_number": "833-368-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 N BROADWAY ST STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401405",
            "telephone_number": "888-655-2078",
            "fax_number": "872-813-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVENT PHARMACY ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "414-223-6874"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Diane Viveen, PA-C
• Vivek Gupta, M.D., S.C. (Omni Healthcare)
• Vivek Pharmacy, Inc.
• Dhayalini Vivek
• Sara Vivens, LPC
• Vivian B Skolnick PHD PC
• Eva Vivian-Jones
• Vivid Physical Therapy LLC
• Vivid Smiles Chicago
• Gesenia Viviescas

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.