WALGREENS #05258 – Pharmacy, NPI 1104832591

WALGREENS #05258 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. 54014190 (IL). The NPI Number for WALGREENS #05258 is 1104832591

Main info

Organization
Name
WALGREENS #05258
NPI
1104832591
Phone
(217) 709-2351
Address
1901 E VOORHEES ST
Authorized Official
KIRA L TAYLOR MANAGER
Enumeration Date
31 July 2006
Last Update Date
25 April 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for WALGREENS #05258

  • 1901, East Voorhees Street, Danville, Vermilion County, Illinois, 61832, United States

    MAILSTOP #790

    DANVILLE, IL 618344509

    Phone: (217) 709-2351

    Fax: (217) 709-2344

    Type: Mailing

  • 1470, South Milwaukee Avenue, Libertyville, Lake County, Illinois, 60048, United States

    LIBERTYVILLE, IL 600483796

    Phone: (847) 247-0641

    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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation due soon

Earliest CMS due date is 2026-06-30 (17 days away).

Enrollment records

1

Earliest due date

2026-06-30

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
O20100930068989OPharmacyIL2026-06-30

What to do next

  • Confirm the due date on the CMS Revalidation Lookup Tool.
  • Complete revalidation in PECOS before the published due date.
  • If you have multiple enrollment records, revalidate each one on its own schedule.

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count2,286220$0
91322Sarscov2 vac 50 mcg/0.5ml im584584$0
90480Admn sarscov2 vacc 1 dose584584$0
G0008Administration of influenza virus vaccine528527$0
90662Influenza vaccine split virus, preservative free387387$0
View full utilization report →

Insurance plans in this area (ZIP 61834)

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Reviews

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Frequently asked questions

How do payers reference WALGREENS #05258?
For WALGREENS #05258, use NPI 1104832591 as the unique 10-digit identifier.
Would WALGREENS #05258 appear as active to a payer?
You can treat WALGREENS #05258 as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with WALGREENS #05258?
WALGREENS #05258's record emphasizes Pharmacy. Clinical services aligned with this taxonomy classification.
Is WALGREENS #05258 located near Danville?
WALGREENS #05258 currently maps to Danville, Illinois in this extract.
Can I trust this NPI listing for WALGREENS #05258?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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