Highland Park CVS LLC
Organization Active NPI Pharmacy · Mt Prospect, IL
NPI 1740384684 · NPPES record last updated Jan 5, 2026
Key facts
- NPI
- 1740384684
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 054-014663 (IL)
- Legal business name
- HIGHLAND PARK CVS LLC
- Practice address
- 1002 S Busse Rd
Mt Prospect, IL 60056-4570 - Phone
- (847) 871-6291
- NPI assigned
- Sep 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Colbert
- Title
- Director, Payer Relations
- Phone
- (401) 770-2751
Corporate family (same tax ID) 24
Member of 1
Practitioners 14
-
Catherine Cwieka, PHARMD
-
Havan Marben, RPH
-
Melissa Mathew, PHARM.D.
-
Kamlesh Patel, RPH
-
Khamara Rowry, PHARM D
-
Hardik M Thakkar, PHARM.D
-
Helen Wondowassen, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2223273 | CVS/Pharmacy #03110 | Certificate of waiver | May 4, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Busse CVS LLC |
Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080103000235 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2860572856 | This NPI is an additional NPI on the enrollment |
| O20100930011243 | IL | DME Supplier - Pharmacy | 4688739402 | Practice locations: Mount Prospect, IL |
National Provider Directory
- Tax ID family
- Highland Park CVS LLC
Locations
1002 S Busse Rd
Mt Prospect, IL 60056
Phone (847) 871-6291
1 Cvs Dr
#175
Woonsocket, RI 02895
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 054-014663 | IL | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1002 S Busse Rd
Mt Prospect, IL 60056-4570
Mailing address
1 CVS Dr
Woonsocket, RI 02895-6146
Phone (401) 765-1500
Other names
- CVS PHARMACY # 03110
- CVS Pharmacy #03110
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Mt Prospect, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.