NPIMap

Organization Active NPI

Walter Lagestee Incorporated

  • Community/Retail Pharmacy
  • Crete, IL
National Provider Identifier
1649355694
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054-11905 Issued in IL
Legal business name
WALTER LAGESTEE INCORPORATED
Practice address
1100 E Exchange St
Crete, IL 60417-3433
Phone
(708) 672-9175
Fax
(708) 672-6845
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Patrick J Egan, PHARMACIST
Title
Third Party Coordinator
Phone
(708) 957-2974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054-11905 IL Primary

Addresses

Primary practice location

1100 E Exchange St
Crete, IL 60417-3433

Mailing address

1100 E Exchange St
Crete, IL 60417-3433
Phone (708) 672-9175

Other names 1

  • Walt's Pharmacy #4 Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1649355694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E EXCHANGE ST",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604173433",
            "telephone_number": "708-672-9175",
            "fax_number": "708-672-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E EXCHANGE ST",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604173433",
            "telephone_number": "708-672-9175",
            "fax_number": "708-672-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER LAGESTEE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "THIRD PARTY COORDINATOR",
        "authorized_official_telephone_number": "708-957-2974",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054-11905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walt's Pharmacy #4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crete, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.