Organization · Type 2 NPI

Walgreen Co

Pharmacy · Decatur, IL

NPI number 1225307986 Active

Practice location

420 W 1st Dr
Decatur, IL 62521-5294

Call (217) 422-3801 Map

Fax (217) 422-3817

Mailing address

1901 E Voorhees St, Ms 790
Danville, IL 61834-4515

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	054.017860 (IL)
Community/Retail Pharmacy	3336C0003X	None listed

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

Another provider at this address

Walgreen Co.Clinical Medical Laboratory Decatur, IL NPI 1639808835

Other pharmacy providers in Decatur

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NPI record

NPI: 1225307986
Entity type: Organization (Type 2)
Issued: Dec 23, 2011
Last updated: Sep 23, 2026
Status: Active
Subpart: Yes of Walgreens Holding Company

Other names

<unavail>
Walgreens #13921 · doing business as
Walgreens #13921 · doing business as

Authorized official

Jennifer Ponce
Manager
(847) 527-2489

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1225307986

Walgreen Co's National Provider Identifier is 1225307986, issued on Dec 23, 2011. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Decatur, IL. The record was last updated on Sep 23, 2026.