WALGREEN CO
NPI 1104831403
Pharmacy in Chicago, IL

Q: What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1104831403. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #04233.

Q: What is Walgreen Co's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Q: When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 29, 2006CLIA 14D2015156 · Waiver

5600 W FULLERTON AVE, CHICAGO, IL 60639(773) 745-1640(773) 745-6413 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Walgreen Co NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALGREEN CO (NPI 1104831403), doing business as Walgreens #04233, is a healthcare organization registered as a pharmacy in Chicago, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 12, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1104831403

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWALGREEN CO

Location Address5600 W FULLERTON AVEChicago, IL 60639-2305

Mailing Address1901 E Voorhees St # Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344

Phone(773) 745-1640

Fax(773) 745-6413

Organization SubpartYesParent: Walgreens Boots Alliance Inc.

Authorized OfficialJennifer PonceManager · (847) 527-2489

Enumeration DateJuly 29, 2006

Last NPPES UpdateAugust 4, 2025

NPPES CertifiedAugust 4, 2025

✔ NPI 1104831403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in IL · 54006490

Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

5600 W FULLERTON AVE, Chicago, IL 60639

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Other Names 1

Doing Business AsWalgreens #04233

Other Identifiers 2

Medicaid362127039233IL

Other1438868Other Id Number-commercial Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2015156

Walgreens #04233 · Chicago, IL

Active · expires May 12, 2027

CLIA Number14D2015156

Laboratory TypePharmacy

Certificate Effective DateMay 13, 2025

Certificate Expiration DateMay 12, 2027

Laboratory DirectorKlaudia Kupinska

Laboratory Phone(773) 745-1640

Laboratory LocationWalgreens #042335600 W Fullerton Ave, Chicago, IL 60639

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

110 services110 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

81 services81 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

45 services44 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

42 services41 patients

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KLAUDIA KUPINSKA RPH

Pharmacist