NPIMap

Organization Active NPI

Walgreen Co

Doing business as Walgreens #16430

  • Pharmacy
  • Chicago, IL
National Provider Identifier
1619346707
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
WALGREEN CO
Doing business as
Walgreens #16430
Practice address
5625 N Ridge Ave Ste a
Ste a
Chicago, IL 60660-3434
Phone
(224) 323-5087
NPI assigned
Sep 18, 2015
Last updated
Nov 9, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Authorized official

Name
Mr. Alan Nielsen
Title
Treasurer
Phone
(847) 315-3523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

5625 N Ridge Ave Ste a
Ste a
Chicago, IL 60660-3434

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (217) 709-2386

Other identifiers 3

IdentifierTypeStateIssuer
054019588OtherILBOARD OF PHARMACY
1491214OtherILNCPDP
362127039006MedicaidIL

Other names 1

  • WALGREENS #16430 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Walgreen Co8,684 organizations share this tax ID, including this one
Part of
Walgreens Holding Company

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5625 N Ridge Ave
#A
Chicago, IL 60660
Phone (224) 323-5087

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1619346707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2386",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 N RIDGE AVE STE A",
            "address_2": "STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603434",
            "telephone_number": "224-323-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2015-09-18",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "847-315-3523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "054019588",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1491214",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362127039006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALGREENS #16430",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.