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WALGREEN CO
NPI 1518972785
Pharmacy in Wauconda, IL

Active since July 29, 2006CLIA 14D2213991 · Waiver
602 W LIBERTY ST, WAUCONDA, IL 60084(847) 487-9383(847) 487-9626 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 19, 2025, Feb 24, 2017, Nov 23, 2016 (3 updates tracked since 2016).

About Walgreen Co NPPES

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

WALGREEN CO (NPI 1518972785), doing business as Walgreens 04277, is a healthcare organization registered as a pharmacy in Wauconda, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 17, 2027 and lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1518972785
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address602 W LIBERTY STWauconda, IL 60084-3405
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4515 · (847) 527-2489 · Fax (217) 709-2344
Phone(847) 487-9383
Fax(847) 487-9626
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateJuly 29, 2006
Last NPPES UpdateNovember 19, 20253 updates tracked since enumeration
NPPES CertifiedNovember 19, 2025
✔ NPI 1518972785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in IL · 54013717
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
602 W LIBERTY ST, Wauconda, IL 60084
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Other Names 1

Doing Business AsWalgreens 04277

Other Identifiers 2

Medicaid362127039277IL
Other1467895Other 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 14D2213991

Walgreens #04277 · Wauconda, IL
Active · expires Feb 17, 2027
CLIA Number14D2213991
Laboratory TypePharmacy
Certificate Effective DateFebruary 18, 2025
Certificate Expiration DateFebruary 17, 2027
Laboratory DirectorJeffrey A. Schotke
Laboratory Phone(847) 487-9383
Laboratory LocationWalgreens #04277602 W Liberty Street, Wauconda, IL 60084
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 2

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.

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.
11 services11 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.
11 services11 patients

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #4277 carries, from the Medicare DMEPOS supplier directory.

Walgreens #4277

DMEPOS supplier · Wauconda, ILOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #4277 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20398679
Medicare Participant SinceMarch 1, 2022
Supplier Location602 W Liberty StWauconda, IL 60084
Phone(847) 487-9383
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 9

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

JUSTIN WOOJIN LEE
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
DR. LISA S BAJOREK PHARMD
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
MRS. BARBARA JEAN JESME R.PH.
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
MRS. LARISSA VERA HANZA RPH
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
HAGOP M SAZIAN PHARM.D.
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
HUNTER LEIGH NOVOSAD PHARMD
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383
AHMAD WEHBI
Pharmacist
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 658-7051
WALGREENS BOOTS ALLIANCE
Pharmacy (Community/Retail Pharmacy)
602 W LIBERTY ST
WAUCONDA, IL 60084
Lake County (847) 487-9383

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 1518972785. It was assigned to this organization in the NPPES registry on July 29, 2006. The provider is doing business as Walgreens 04277.

Where is Walgreen Co located?

Walgreen Co is located at 602 W Liberty St, Wauconda, IL 60084. The listed phone number is (847) 487-9383.

What is Walgreen Co's specialty?

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

Does Walgreen Co accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #4277 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreen Co hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2213991) is associated with this NPI, valid through February 17, 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 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.