Walgreen Co.
Organization Active NPI Clinical Medical Laboratory · Romeoville, IL
NPI 1144959321 · NPPES record last updated Jun 6, 2022
Key facts
- NPI
- 1144959321
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- WALGREEN CO.
- Practice address
- 347 N Independence Blvd
Romeoville, IL 60446-1558 - Phone
- (815) 293-1152
- Fax
- (815) 293-1165
- NPI assigned
- Jun 6, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- WALGREENS BOOTS ALLIANCE INC
Authorized official
- Name
- Kira L Taylor
- Title
- Manager
- Phone
- (217) 709-2351
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2215292 | Walgreens #11195 | Certificate of waiver | Mar 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200716003789 | IL | Part B Supplier - Independent Clinical Laboratory | 0941278253 | This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Walgreen Co
- Part of
- Walgreens Holding Company
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
347 N Independence Blvd
Romeoville, IL 60446-1558
Mailing address
1901 E Voorhees St # Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351
Other names
- WALGREENS #11195
Other providers in Romeoville, IL
- Vna Health Care
- Walgreen Co
- Walgreen Co
- Walgreen Co
- Walgreen Co
- Walgreen Co.
- Walgreen Co.
- Walmart Inc.
- Wannemacher Therapy Services, P.C.
- Waqas Tariq Medical LLC
All providers in Romeoville, IL · Clinical Medical Laboratory in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2022. 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.