NPIMap

Organization Active NPI

Prime Plus Lakeview LLC

  • Community/Retail Pharmacy
  • Chicago, IL
National Provider Identifier
1306954433
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054005995 Issued in IL
Legal business name
PRIME PLUS LAKEVIEW LLC
Practice address
3156 N Clark St
Chicago, IL 60657
Phone
(773) 568-8340
Fax
(773) 568-8341
NPI assigned
Aug 28, 2006
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Amro Atassi
Title
Manager
Phone
(773) 568-8340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054005995 IL Primary

Addresses

Primary practice location

3156 N Clark St
Chicago, IL 60657

Mailing address

3156 N Clark St
Chicago, IL 60657
Phone (773) 568-8340

Other identifiers 2

IdentifierTypeStateIssuer
1431523OtherILNABP/NCPDP
=========MedicaidIL

National Provider Directory

National Provider Directory

Locations

3156 N Clark St
Chicago, IL 60657
Phone (773) 568-8340

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1306954433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-568-8340",
            "fax_number": "773-568-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3156 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-568-8340",
            "fax_number": "773-568-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PLUS LAKEVIEW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "ATASSI",
        "authorized_official_first_name": "AMRO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-568-8340"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054005995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP/NCPDP",
            "identifier": "1431523",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.