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WALGREENS #10485
NPI 1194730408
Pharmacy in Calumet Park, IL

Active since July 29, 2006CLIA 14D2049154 · Waiver
12854 S ASHLAND AVE, CALUMET PARK, IL 60827(708) 239-1136 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 3, 2023, Mar 8, 2022 (2 updates tracked since 2022).

About Walgreens #10485 NPPES

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

WALGREENS #10485 (NPI 1194730408) is a healthcare organization registered as a pharmacy in Calumet Park, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 11, 2027 and lists Kira L Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1194730408
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address12854 S ASHLAND AVECalumet Park, IL 60827-6308
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (217) 709-2351 · Fax (217) 709-2344
Phone(708) 239-1136
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialKira L TaylorManager · (217) 709-2351
Enumeration DateJuly 29, 2006
Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration
NPPES CertifiedNovember 3, 2023
✔ NPI 1194730408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in IL · 54007200
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
12854 S ASHLAND AVE, Calumet Park, IL 60827
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Other Names 1

Doing Business AsWalgreens #10485

Other Identifiers 1

Other1442576Other 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 14D2049154

Walgreens #10485 · Calumet Park, IL
Active · expires May 11, 2027
CLIA Number14D2049154
Laboratory TypePharmacy
Certificate Effective DateMay 12, 2025
Certificate Expiration DateMay 11, 2027
Laboratory DirectorSolomon A. Tam
Laboratory Phone(708) 239-1136
Laboratory LocationWalgreens #1048512854 S Ashland Ave, Calumet Park, IL 60827
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 3

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.
56 services56 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.
34 services34 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
17 services17 patients

Other Providers at the Same Location NPPES 3

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

TIAJUANA DIXON
Pharmacist
12854 S ASHLAND AVE
CALUMET PARK, IL 60827
Cook County (708) 239-1136
DAWN L RUSH
Pharmacist
12854 S ASHLAND AVE
CALUMET PARK, IL 60827
Cook County (708) 239-1136
WALGREEN CO.
Clinical Medical Laboratory
12854 S ASHLAND AVE
CALUMET PARK, IL 60827
Cook County (708) 239-1136

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walgreen Co's NPI number?

The NPI number for Walgreen Co is 1194730408. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens #10485.

Where is Walgreen Co located?

Walgreen Co is located at 12854 S Ashland Ave, Calumet Park, IL 60827. The listed phone number is (708) 239-1136.

What is Walgreen Co's specialty?

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

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2049154) is associated with this NPI, valid through May 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walgreen Co accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 40 other insurers list Walgreen Co as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Walgreen Co was last updated on November 3, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.