Walgreen Co
NPI 1093720203ActiveOrganization· Pharmacy· Broadview, IL
Pharmacy in Broadview, Illinois, registered in NPPES in July 2006, part of Walgreens Boots Alliance, Inc. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $58,634 for services to 229 patients in 2024.
Overview
| NPI | 1093720203 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Boots Alliance, Inc |
| NPI issued | Jul 29, 2006 |
| Last updated in NPPES | May 14, 2026 |
| Certified by provider | May 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 054.015344 | IL |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 229 |
|---|---|
| Services billed | 738 across 11 procedure codes |
| Paid by Medicare | $58,634 |
Other Pharmacy providers in Broadview
- 1699797407
- 1891700936