Walgreen Co
Pharmacy in Chicago, IL. Organization (NPI-2).
NPI number1104831403
StatusActive
Last updated in NPPESAug 4, 2025
Details
- NPI
- 1104831403
- Entity type
- Organization (NPI-2)
- Legal business name
- Walgreen Co
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2006
- Certification date
- Aug 4, 2025
- Last updated
- Aug 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 54006490 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walgreens #04233 (Doing Business As)
Practice location
5600 W Fullerton AveChicago, IL 60639-2305
Phone 773-745-1640 · Fax 773-745-6413
Mailing address
1901 E Voorhees St # Ms 790Danville, IL 61834-4515
Phone 847-527-2489 · Fax 217-709-2344
Authorized official
Jennifer Ponce
Manager
8475272489
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