WALGREENS #05107 – Pharmacy, NPI 1184639361

WALGREENS #05107 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. 54014206 (IL). The NPI Number for WALGREENS #05107 is 1184639361

Main info

Organization
Name
WALGREENS #05107
NPI
1184639361
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
1 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 #05107

  • 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

  • 1701, East Kensington Road, Mount Prospect, Wheeling Township, Cook County, Illinois, 60056, United States

    MT PROSPECT, IL 600561922

    Phone: (847) 635-9962

    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 2025-10-31 (219 days ago).

Enrollment records

1

Earliest due date

2025-10-31

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
O20100930000726OPharmacyIL2025-10-31

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.

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 count1,936194$0
G0008Administration of influenza virus vaccine350350$0
91320Sarscv2 vac 30mcg trs-suc im333333$0
90480Admn sarscov2 vacc 1 dose333333$0
90662Influenza vaccine split virus, preservative free237237$0
View full utilization report →

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 #05107 for billing?
Administrative and clinical systems typically use NPI 1184639361 for WALGREENS #05107.
Quick check: is WALGREENS #05107 active?
Public NPPES data shows WALGREENS #05107 with an active NPI status right now.
What does the directory say WALGREENS #05107 does?
Insurance directories may phrase it differently, but here WALGREENS #05107 maps to Pharmacy. Clinical services aligned with this taxonomy classification.
Is WALGREENS #05107 tied to Danville, Illinois?
If you are local to Danville, Illinois, WALGREENS #05107 may be relevant to your search.
Who maintains WALGREENS #05107's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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