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	054.019019	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1402546	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1336154467
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	:	3405 S KING DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-4108
Country	:	US
Telephone Number	:	312-326-4058
Fax Number	:	312-326-0773

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	:	11/02/2023

Similar Medicare Providers

1437174299 — DR. TERESA HASKINS M.D., MPH
Practice Location Address:

3473 S KING DR , STE # 511
CHICAGO, IL
60616-4108

Practice Phone: 888-205-0893
Practice Fax: 888-205-0893

1598927410 — TONIA LARITA NICHOLSON-FLOWERS
Practice Location Address:

3473 S KING DR , SUITE 378
CHICAGO, IL
60616-4108

Practice Phone: 773-403-5836
Practice Fax: 708-260-9396

1912280082 — SAMRA ZVIZDIC PHARMD
Practice Location Address:

3405 S M L KING DR
CHICAGO, IL
60616-4108

Practice Phone: 312-326-4058
Practice Fax:

1043597149 — SOLOMON TAM PHARM D
Practice Location Address:

3405 S KING DR
CHICAGO, IL
60616-4108

Practice Phone: 312-326-4058
Practice Fax:

1952688053 — KEVIN C SWANSON PHARM D.
Practice Location Address:

3405 S M L KING DR
CHICAGO, IL
60616-4108

Practice Phone: 312-326-4058
Practice Fax:

1114204617 — DR. JIMMY C LIANG PHARMD
Practice Location Address:

3405 S M L KING DR
CHICAGO, IL
60616-4108

Practice Phone: 312-326-4058
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 © 2007-2025 (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.