MEDICARE: WALGREEN CO

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	54007200	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1442576	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1194730408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALGREEN CO

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST
Second Line	:	MS 790
City	:	DANVILLE
State	:	IL
Zip	:	61834-4509
Country	:	US
Telephone Number	:	217-709-2351
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	12854 S ASHLAND AVE
Second Line	:
City	:	CALUMET PARK
State	:	IL
Zip	:	60827-6308
Country	:	US
Telephone Number	:	708-239-1136
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KIRA L TAYLOR
Credential	:
Telephone Number	:	217-709-2351

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	11/03/2023

Similar Medicare Providers

1235414004 — DAWN L RUSH
Practice Location Address:

12854 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 708-239-1136
Practice Fax: 708-239-1146

1043588205 — TIAJUANA DIXON
Practice Location Address:

12854 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 708-239-1136
Practice Fax:

1700429040 — WILLIAM SIDERAS PA-C
Practice Location Address:

12850 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 630-581-5372
Practice Fax:

1982298469 — MIDWEST EXPRESS CARE 2, INC
Practice Location Address:

12850 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 708-972-7958
Practice Fax: 708-972-7969

1851969976 — MS. KATARZYNA PARA FNP-C
Practice Location Address:

12850 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 708-972-7958
Practice Fax:

1184371668 — CAITLIN GREENFIELD FNP-BC
Practice Location Address:

12850 S ASHLAND AVE
CALUMET PARK, IL
60827-6308

Practice Phone: 708-972-7958
Practice Fax:

Directions to “WALGREEN CO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.