Provider Demographics
NPI:1992081988
Name:WALGREENS
Entity type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:OSTER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:815-973-6327
Mailing Address - Street 1:822 E MORGAN ST
Mailing Address - Street 2:822 E. MORGAN ST.
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-2260
Mailing Address - Country:US
Mailing Address - Phone:815-973-6327
Mailing Address - Fax:
Practice Address - Street 1:1275 N GALENA AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-1001
Practice Address - Country:US
Practice Address - Phone:815-288-7844
Practice Address - Fax:815-288-6953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.0338253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy