Interdependent Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

INTERDEPENDENT PHARMACY, LLC

Doing business as

Lakes Apothecary

Practice address

404 N Seymour Ave
Mundelein, IL 60060-1835

Phone

(224) 475-0020

Fax

(224) 475-0849

NPI assigned

Apr 7, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Byron Strakusek, RPH.NPI 1811421340

Title

Owner

Phone

(224) 392-2666

Specialties & licenses 2

Addresses

Other names 1

• Lakes Apothecary Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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.

• Byron Strakusek, RPH.

  • Pharmacist
  • Mundelein, IL
  • NPI 1811421340
  NPD Authorized official
• James Michael Kavanaugh, RPH

  • Pharmacist
  • Mundelein, IL
  • NPI 1235718792
  NPD (past)
• Cassandra Thomas, RPH

  • Pharmacist
  • Mundelein, IL
  • NPI 1932788395
  NPD (past)

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316470123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 SOMERSET LN",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600605363",
            "telephone_number": "224-392-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N SEYMOUR AVE",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601835",
            "telephone_number": "224-475-0020",
            "fax_number": "224-475-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 N Seymour Ave",
            "address_purpose": "LOCATION",
            "city": "Mundelein",
            "state": "IL",
            "postal_code": "600602318",
            "country_code": "US",
            "telephone_number": "224-392-2666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERDEPENDENT PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STRAKUSEK",
        "authorized_official_first_name": "BYRON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-392-2666",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "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": [
        {
            "organization_name": "Lakes Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mundelein, IL
• Providers in Mundelein, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.