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	054.019248	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1457022	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1619983152
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	:	4343 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1301
Country	:	US
Telephone Number	:	773-604-4419
Fax Number	:	773-604-5235

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/30/2022

Similar Medicare Providers

1033490057 — RAYMOND J SAVASTIO RPH
Practice Location Address:

4343 N KEDZIE AVE
CHICAGO, IL
60618-1301

Practice Phone: 773-604-4419
Practice Fax:

1861774499 — WENDY NG PHARM D
Practice Location Address:

4343 N KEDZIE AVE
CHICAGO, IL
60618-1301

Practice Phone: 773-604-4419
Practice Fax:

1144793688 — MICHELLE YUNJEE JEONG
Practice Location Address:

4343 N KEDZIE AVE
CHICAGO, IL
60618-1301

Practice Phone: 773-603-4419
Practice Fax:

1548111966 — JONATHAN J MARIN
Practice Location Address:

4343 N KEDZIE AVE
CHICAGO, IL
60618-1301

Practice Phone: 773-604-4419
Practice Fax:

1538002431 — JORDAN KLEMT M.S., CCC-SLP
Practice Location Address:

1301 E 47TH ST
CHICAGO, IL
60653-4507

Practice Phone: 773-324-6400
Practice Fax:

1760323349 — CAROLINE A. LOEB, M.D. PLLC
Practice Location Address:

1301 N DEARBORN ST APT 703
CHICAGO, IL
60610-6096

Practice Phone: 773-209-2997
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.