WALGREENS #04706 – Pharmacy, NPI 1164439147

WALGREENS #04706 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. PH0008201 (FL). The NPI Number for WALGREENS #04706 is 1164439147

Main info

Organization
Name
WALGREENS #04706
NPI
1164439147
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
2 August 2006
Last Update Date
22 October 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness90
Years active:19State licenses:1Digital endpoints

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Provider Addresses for WALGREENS #04706

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

    MS 790

    DANVILLE, IL 618344515

    Phone: (847) 527-2489

    Fax: (217) 709-2344

    Type: Mailing

  • Coconut Creek Parkway, Hammondville, Margate, Broward County, Florida, 33063, United States

    COCONUT CREEK, FL 330633902

    Phone: (954) 975-0800

    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)

Past revalidation due date

Earliest CMS due date was 2025-11-30 (191 days ago).

Enrollment records

1

Earliest due date

2025-11-30

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
O20100930036424OPharmacyFL2025-11-30

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.

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 count2,747289$0
G0008Administration of influenza virus vaccine275275$0
91320Sarscv2 vac 30mcg trs-suc im252252$0
90480Admn sarscov2 vacc 1 dose252252$0
90694Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage156156$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 #04706?
For WALGREENS #04706, use NPI 1164439147 as the unique 10-digit identifier.
Is WALGREENS #04706 still an active registrant?
WALGREENS #04706 carries an active NPI according to the public dataset.
What kind of doctor is WALGREENS #04706?
WALGREENS #04706 is associated with Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
Where in Illinois is WALGREENS #04706 registered?
Use Danville, Illinois as the headline location for WALGREENS #04706 here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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