Walgreen Co
NPI 1104832591ActiveOrganization· Pharmacy· Libertyville, IL
Pharmacy in Libertyville, Illinois, registered in NPPES in July 2006, part of Walgreens Boots Alliance Inc. The authorized official on file is Jennifer Ponce, Manager. Medicare paid $175,882 for services to 639 patients in 2024.
Overview
| NPI | 1104832591 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Walgreens Boots Alliance Inc |
| NPI issued | Jul 31, 2006 |
| Last updated in NPPES | May 14, 2026 |
| Certified by provider | May 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 54014190 | 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 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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 | 639 |
|---|---|
| Services billed | 2,138 across 12 procedure codes |
| Paid by Medicare | $175,882 |
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