NPIMap

Walgreen Co.

Organization Active NPI Clinical Medical Laboratory · Lakemoor, IL

NPI 1154069573 · NPPES record last updated May 25, 2022

Key facts

NPI
1154069573
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
WALGREEN CO.
Practice address
28895 W Il Route 120
Lakemoor, IL 60051-7258
Phone
(815) 578-9346
Fax
(815) 578-9375
NPI assigned
May 25, 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

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2069710Walgreens #11367
28895 W Il Route 120, Lakemoor, IL 60051		Certificate of waiverJun 21, 2027

National Provider Directory

Tax ID family
Walgreen Co (8,684 organizations share this tax ID)
Part of
Walgreens Holding Company

Locations

28895 W State Route 120
Lakemoor, IL 60051
Phone (815) 578-9346

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

28895 W Il Route 120
Lakemoor, IL 60051-7258

Mailing address

1901 E Voorhees St # Ms 790
Danville, IL 61834-4509
Phone (217) 709-2351

Other names

  • Walgreens #11367 Doing business as

Other providers in Lakemoor, IL

All providers in Lakemoor, IL · Clinical Medical Laboratory in Illinois

Sources for this page

Verify at the official NPI Registry.