MEDICARE: WALGREENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	051299772	IL

General Provider Information

NPI Number	:	1083169841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREENS

Provider Business Mailing Address
First Line	:	8120 S COLFAX AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-1201
Country	:	US
Telephone Number	:	773-470-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	5036 S COTTAGE GROVE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2642
Country	:	US
Telephone Number	:	773-373-6266
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	CARLINE JOSEPH
Credential	:
Telephone Number	:	773-470-9831

Provider Enumeration Date	:	08/22/2016
Last Update Date	:	08/22/2016

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Directions to “WALGREENS ” Practice Location

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