WALGREENS #04948 – Pharmacy, NPI 1467469494

WALGREENS #04948 is a healthcare provider. based in Bolingbrook, Illinois. specializing in Pharmacy. The organization holds a License No. 54004590 (IL). The NPI Number for WALGREENS #04948 is 1467469494

Main info

Organization
Name
WALGREENS #04948
NPI
1467469494
Phone
(630) 759-3011
Address
101 LILY CACHE LN
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
2 August 2006
Last Update Date
9 September 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 #04948

  • Walgreens, 101, Lily Cache Lane, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404895

    Phone: (630) 759-3011

    Type: Location

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

    MS 790

    DANVILLE, IL 618344515

    Phone: (847) 527-2489

    Fax: (217) 709-2386

    Type: Mailing

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: 2017-01-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-09-30 (254 days ago).

Enrollment records

1

Earliest due date

2025-09-30

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
O20170119001970OPharmacyIL2025-09-30

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.

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

Insurance plans in this area (ZIP 60440)

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Reviews

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Frequently asked questions

Is there an official ID for WALGREENS #04948 in U.S. healthcare records?
The official identifier for WALGREENS #04948 is NPI 1467469494.
Is WALGREENS #04948 still an active registrant?
WALGREENS #04948 carries an active NPI according to the public dataset.
What kind of doctor is WALGREENS #04948?
WALGREENS #04948 is associated with Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for WALGREENS #04948?
Travel planning: use Bolingbrook, Illinois as the reference point for WALGREENS #04948, then confirm.
When was this NPI issued?
Enumeration for WALGREENS #04948 is noted as August 2, 2006 where the registry provides it.

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