| NPI | 1003048505 |
|---|---|
| Doing Business As | WALGREENS #12053 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER PONCE Manager 847-527-2489 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WA CF60112435) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2026-02-10 |