WALGREENS #15793 – Community/Retail Pharmacy, NPI 1639157092

WALGREENS #15793 is a healthcare provider. based in Danville, Illinois. specializing in Community/Retail Pharmacy. The organization holds a License No. AR20069 (AR). The NPI Number for WALGREENS #15793 is 1639157092

Main info

Organization
Name
WALGREENS #15793
NPI
1639157092
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
5 January 2006
Last Update Date
8 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience83
Completeness90
Years active:20State licenses:2Digital endpoints

Provider Addresses for WALGREENS #15793

  • 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

  • 803 HIGHWAY 71 N

    MENA, AR 719534367

    Phone: (479) 394-5144

    Fax: (479) 394-2167

    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: 2013-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (280 days ago).

Enrollment records

1

Earliest due date

2025-08-31

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
O20130830000624OPharmacyAR2025-08-31

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

Is there an official ID for WALGREENS #15793 in U.S. healthcare records?
The official identifier for WALGREENS #15793 is NPI 1639157092.
Is WALGREENS #15793 shown as active in public data?
Registry records indicate WALGREENS #15793 maintains an active NPI.
What kind of doctor is WALGREENS #15793?
WALGREENS #15793 is associated with Community/Retail Pharmacy in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with WALGREENS #15793?
Directory geography for WALGREENS #15793 centers on Danville, Illinois.
Can I trust this NPI listing for WALGREENS #15793?
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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