| NPI | 1912180894 |
|---|---|
| Other Name | WALGREENS #11339 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER PONCE Manager 847-527-2489 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WI 8799-042) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2025-10-20 |