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WALGREENS
NPI 1912284811
Point of Service in Oak Forest, IL

Active since November 07, 2011CLIA 14D2224658 · Waiver
5525 159TH ST, OAK FOREST, IL 60452(708) 535-6018(708) 535-7412 Get Directions Write a Review

NPPES record last updated: November 7, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Walgreens NPPES

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

WALGREENS (NPI 1912284811) is a healthcare organization registered as a point of service in Oak Forest, Illinois and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through May 13, 2027 and lists Michael Anthony Mennella, Pharmacy Manager, as its authorized official.

NPPES Registry Identity

NPI1912284811
Entity TypeOrganization
Primary Taxonomy305S00000X
Legal Business NameWALGREENS
Location Address5525 159TH STOak Forest, IL 60452-3223
Mailing Address5525 159th StOak Forest, IL 60452-3223
Phone(708) 535-6018
Fax(708) 535-7412
Organization SubpartNo
Authorized OfficialMichael Anthony MennellaPharmacy Manager · (708) 535-6018
Enumeration DateNovember 7, 2011
✔ NPI 1912284811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPoint of ServiceManaged Care Organizations
Taxonomy Code305S00000X
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
5525 159TH ST, Oak Forest, IL 60452
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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 14D2224658

Walgreens #05104 · Oak Forest, IL
Active · expires May 13, 2027
CLIA Number14D2224658
Laboratory TypePharmacy
Certificate Effective DateMay 14, 2025
Certificate Expiration DateMay 13, 2027
Laboratory DirectorKenneth C. Sebastian
Laboratory Phone(708) 535-6018
Laboratory LocationWalgreens #051045525 159th St, Oak Forest, IL 60452
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Walgreens #5104 carries, from the Medicare DMEPOS supplier directory.

Walgreens #5104

DMEPOS supplier · Oak Forest, ILOperated by Walgreen Co
✔

Accepts Medicare assignment

Walgreens #5104 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)20391227
Medicare Participant SinceMarch 1, 2022
Supplier Location5525 159th StOak Forest, IL 60452
Phone(708) 535-6018
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 4

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

THERESE A FUNK RPH
Pharmacist
5525 159TH ST
OAK FOREST, IL 60452
Cook County (708) 535-6018
WALGREEN CO
Pharmacy
5525 159TH ST
OAK FOREST, IL 60452
Cook County (708) 535-0974
REBECCA DENO
Pharmacist
5525 159TH ST
OAK FOREST, IL 60452
Cook County (708) 535-6018
MICHAEL ANTHONY MENNELLA PHARM D
Pharmacist
5525 159TH ST
OAK FOREST, IL 60452
Cook County (708) 535-6018

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 Walgreens's NPI number?

The NPI number for Walgreens is 1912284811. It was assigned to this organization in the NPPES registry on November 7, 2011.

Where is Walgreens located?

Walgreens is located at 5525 159th St, Oak Forest, IL 60452. The listed phone number is (708) 535-6018.

What is Walgreens's specialty?

The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.

Does Walgreens accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Walgreens #5104 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Walgreens hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2224658) is associated with this NPI, valid through May 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walgreens was last updated on November 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.