MEDICARE: AMERICAN DRUG STORES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	054-003676	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2022371	OTHER		PK

General Provider Information

NPI Number	:	1275571416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN DRUG STORES LLC

Provider Business Mailing Address
First Line	:	250 E PARKCENTER BLVD
Second Line	:	MAILSTOP SEC2-B
City	:	BOISE
State	:	ID
Zip	:	83706-3940
Country	:	US
Telephone Number	:	208-395-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3531 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657
Country	:	US
Telephone Number	:	773-528-6615
Fax Number	:	773-404-6916

Authorized Official
Title or Position	:	ENROLLMENT ASSISTANT MANAGER
Name	:	TIFFANY ELIOPULOS
Credential	:
Telephone Number	:	208-395-3906

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	06/28/2018

Similar Medicare Providers

1356164552 — ANGELA RUTH CARTER RN
Practice Location Address:

3209 N LAKEWOOD AVE
CHICAGO, IL
60657-3215

Practice Phone: 312-279-9981
Practice Fax:

1487900379 — MALIHA KHAN M.D.
Practice Location Address:

2900 N LAKE SHORE DR
CHICAGO, IL
60657-5640

Practice Phone: 630-276-6809
Practice Fax:

1770446569 — MICHAEL ANDREW PULTE APRN
Practice Location Address:

3110 N SHERIDAN RD APT 1210
CHICAGO, IL
60657-4941

Practice Phone: 616-970-3906
Practice Fax:

1326822453 — ORTHODONTIC EXPERTS LTD
Practice Location Address:

3113 N HALSTED ST
CHICAGO, IL
60657-4436

Practice Phone: 815-340-1046
Practice Fax:

1316800980 — PIVOT BEHAVIORAL HEALTH, PLLC
Practice Location Address:

611 W BRIAR PL STE 6
CHICAGO, IL
60657-4560

Practice Phone: 773-234-1721
Practice Fax:

1124982749 — MARIA SUZANA PEREZ PMHNP-BC
Practice Location Address:

2845 N SHERIDAN RD
CHICAGO, IL
60657-7227

Practice Phone: 773-649-4261
Practice Fax:

1033616933 — ABIGAIL EVE LEVIN LCSW
Practice Location Address:

2835 N SHEFFIELD AVE STE 402
CHICAGO, IL
60657-5084

Practice Phone: 847-767-1453
Practice Fax:

Directions to “AMERICAN DRUG STORES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.