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NPI Code Detail

MEDICARE: WALGREENS

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
1261QC1500XCommunity Health Clinic/Center051292802IL

General Provider Information

NPI Number : 1699050641
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALGREENS
Provider Business Mailing Address
First Line : 1844 N LINCOLN AVE
Second Line : APT 1
City : CHICAGO
State : IL
Zip : 60614-7799
Country : US
Telephone Number : 217-494-8283
Fax Number :
Provider Business Practice Location Address
First Line : 3019 W PETERSON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-3726
Country : US
Telephone Number : 773-728-6254
Fax Number :
Authorized Official
Title or Position : PHARMACIST
Name : LAUREN MOJA
Credential :
Telephone Number : 773-728-6254
Provider Enumeration Date : 10/20/2011
Last Update Date : 10/20/2011

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Directions to “WALGREENS ” Practice Location

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