NPIMap

Organization Active NPI

Walgreens

  • Pharmacist
  • Des Plaines, IL
National Provider Identifier
1447532973
Registry record updated Sep 10, 2011
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Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051033685 Issued in IL
Legal business name
WALGREENS
Practice address
21 Rand Road
Des Plaines, IL 60016-7529
Phone
(847) 296-6457
NPI assigned
Sep 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Scott Diveney, PHARM-D
Title
Pharmacy Supervisor
Phone
(847) 465-0975

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 051033685 IL Primary

Addresses

Primary practice location

21 Rand Road
Des Plaines, IL 60016-7529

Mailing address

21 Rand Road
Des Plaines, IL 60016-7529
Phone (847) 296-6457

Other identifiers 1

IdentifierTypeStateIssuer
361924025690MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315612800000",
    "number": "1447532973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 RAND ROAD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600167529",
            "telephone_number": "847-296-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 RAND ROAD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600167529",
            "telephone_number": "847-296-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-10",
        "last_updated": "2011-09-10",
        "status": "A",
        "authorized_official_last_name": "DIVENEY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "847-465-0975",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM-D"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051033685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361924025690",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.