WALGREENS SPECIALTY PHARMACY #15283
NPI 1558636555
Pharmacy in Champaign, IL

Active since March 09, 2012
101 W UNIVERSITY AVE STE 102, CHAMPAIGN, IL 61820(217) 366-1278(217) 366-6897 Get Directions Write a Review

NPPES record last updated: December 2, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 2, 2024, Apr 27, 2022, Jan 14, 2016 (3 updates tracked since 2016).

About Walgreens Specialty Pharmacy #15283 NPPES

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

WALGREENS SPECIALTY PHARMACY #15283 (NPI 1558636555) is a healthcare organization registered as a pharmacy in Champaign, Illinois and active in the NPI registry since March 2012. The organization lists Jennifer Ponce, Manager, as its authorized official.

NPPES Registry Identity

NPI1558636555
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALGREEN CO
Location Address101 W UNIVERSITY AVE STE 102Champaign, IL 61820-3909
Mailing Address1901 E Voorhees St, Ms 790Danville, IL 61834-4509 · (847) 527-2489 · Fax (217) 709-2344
Fax(217) 366-6897
Organization SubpartYesParent: Walgreens Boots Alliance Inc
Authorized OfficialJennifer PonceManager · (847) 527-2489
Enumeration DateMarch 9, 2012
Last NPPES UpdateDecember 2, 20243 updates tracked since enumeration
NPPES CertifiedDecember 2, 2024
NPI 1558636555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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
101 W UNIVERSITY AVE STE 102, Champaign, IL 61820

Other Names 1

Doing Business AsWalgreens Specialty Pharmacy #15283

Other Identifiers 1

Other1486566Ncpdp

Accepted Insurance

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20388755
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • 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
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Other Providers at the Same Location NPPES 2

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

Pharmacist
101 W UNIVERSITY AVE STE 102
CHAMPAIGN, IL 61820
Pharmacist
101 W UNIVERSITY AVE STE 102
CHAMPAIGN, IL 61820

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558636555, enumerated as an "organization" on March 09, 2012.

The provider is located at 101 W UNIVERSITY AVE STE 102 CHAMPAIGN, IL 61820 and the phone number is (217) 366-1278.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.