Walgreen Co.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WALGREEN CO.

Practice address

4040 N Cicero Ave
Chicago, IL 60641-1807

Phone

(773) 283-5321

NPI assigned

Apr 6, 2022

Organization subpart

Yes

Parent organization

WALGREENS BOOTS ALLIANCE INCAs reported in NPPES

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

Authorized official

Name

Kira L Taylor

Title

Manager

Phone

(217) 709-2351

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Walgreens #4936 Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Part of

Walgreens Holding Company

Locations

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.

• Walgreens Boots Alliance

  • Community/Retail Pharmacy
  • Wauconda, IL
  • NPI 1831978451
  NPPES parent name

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1699416271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST # MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "217-709-2351",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411807",
            "telephone_number": "773-283-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALGREEN CO.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS BOOTS ALLIANCE INC",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KIRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-709-2351"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1440990",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens #4936",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.
• Walgreen Co.

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.