WALGREENS #9947 – Pharmacy, NPI 1063763134

WALGREENS #9947 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. 28274 (TX). The NPI Number for WALGREENS #9947 is 1063763134

Main info

Organization
Name
WALGREENS #9947
NPI
1063763134
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
28 September 2012
Last Update Date
9 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:13State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for WALGREENS #9947

  • 1901 E VOORHEES ST

    MS 790

    DANVILLE, IL 618344509

    Phone: (847) 527-2489

    Fax: (217) 709-2344

    Type: Mailing

  • 107 E OVILLA RD

    RED OAK, TX 751542445

    Phone: (972) 576-3303

    Fax: (972) 576-3716

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-02-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (586 days ago).

Enrollment records

1

Earliest due date

2024-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20130208000421OPharmacyTX2024-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61834)

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Reviews

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Frequently asked questions

What number should I use to identify WALGREENS #9947 for billing?
Administrative and clinical systems typically use NPI 1063763134 for WALGREENS #9947.
Quick check: is WALGREENS #9947 active?
Public NPPES data shows WALGREENS #9947 with an active NPI status right now.
How should patients interpret WALGREENS #9947's specialty?
The extract shows Pharmacy for WALGREENS #9947. Clinical services aligned with this taxonomy classification.
Which community is linked to WALGREENS #9947?
WALGREENS #9947 shows a connection to Danville, Illinois in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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