WALGREEN CO NPI 1740617984

NPI Information

  • NPI: 1740617984
  • Provider Name: WALGREEN CO
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • :
  • CLIA Number: 14D2069710
  • Address: 28895 W IL RTE 120
    LAKEMOOR, IL
    ZIP 60051
  • Phone: (815) 578-9346

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NPI Details

WALGREEN CO is a pharmacy in Lakemoor, IL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WALGREEN CO NPI is 1740617984. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

28895 W IL RTE 120
LAKEMOOR, IL
ZIP 60051-258
Phone: (815) 578-9346
Fax: (815) 578-9375

The provider's authorized official is Jennifer Ponce .
The authorized official title is Manager and has the following contact phone number (847) 527-2489.

The CLIA number assigned to this NPI record is 14D2069710 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2013 and was last updated on 10/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacy054.019317ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11488433OTHERILLINOISNCPDP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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