Organization Active NPI

Walter Lagestee Incorporated

Doing business as Walt's Pharmacy #3

  • Community/Retail Pharmacy
  • Tinley Park, IL
National Provider Identifier
1740365782
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054-11906 Issued in IL
Legal business name
WALTER LAGESTEE INCORPORATED
Doing business as
Walt's Pharmacy #3
Practice address
16039 Harlem Ave
Tinley Park, IL 60477-1611
Phone
(708) 532-5775
Fax
(708) 532-7262
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, PHARMACISTNPI 1649325325
Title
Third Party Coordinator
Phone
(708) 957-2974

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054-11906 IL Primary

Addresses

Primary practice location

16039 Harlem Ave
Tinley Park, IL 60477-1611

Mailing address

16039 Harlem Ave
Tinley Park, IL 60477-1611
Phone (708) 532-5775

Other names 1

  • Walt's Pharmacy #3 Doing business as

National Provider Directory

National Provider Directory

Locations

2345 183rd St
Homewood, IL 60430
Phone (708) 957-2974

1218 Sheffield Ave
Dyer, IN 46311
Phone (219) 865-4363

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1740365782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16039 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771611",
            "telephone_number": "708-532-5775",
            "fax_number": "708-532-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16039 HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771611",
            "telephone_number": "708-532-5775",
            "fax_number": "708-532-7262"
        }
    ],
    "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": "054-11906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walt's Pharmacy #3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinley Park, 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.