Provider Demographics
NPI:1184051138
Name:WALGREEN CO./ILL.
Entity type:Organization
Organization Name:WALGREEN CO./ILL.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTURO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:815-397-1587
Mailing Address - Street 1:230 W CHRYSLER DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-6304
Mailing Address - Country:US
Mailing Address - Phone:815-544-4790
Mailing Address - Fax:
Practice Address - Street 1:230 W CHRYSLER DR
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-6304
Practice Address - Country:US
Practice Address - Phone:815-544-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local