Provider Demographics
NPI:1831978451
Name:WALGREENS BOOTS ALLIANCE
Entity type:Organization
Organization Name:WALGREENS BOOTS ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAJOREK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:847-873-9925
Mailing Address - Street 1:1190 THORNWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-5038
Mailing Address - Country:US
Mailing Address - Phone:847-873-9925
Mailing Address - Fax:
Practice Address - Street 1:602 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-3405
Practice Address - Country:US
Practice Address - Phone:847-487-9383
Practice Address - Fax:847-487-9626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy