WALGREENS #05213 – Pharmacy, NPI 1679588644

WALGREENS #05213 is a healthcare provider. based in Danville, Illinois. specializing in Pharmacy. The organization holds a License No. 19576 (TX). The NPI Number for WALGREENS #05213 is 1679588644

Main info

Organization
Name
WALGREENS #05213
NPI
1679588644
Phone
(847) 527-2489
Address
1901 E VOORHEES ST
Authorized Official
JENNIFER PONCE MANAGER
Enumeration Date
29 July 2006
Last Update Date
21 November 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 #05213

  • 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

  • 750, North Walnut Creek Drive, Mansfield, Tarrant County, Texas, 76063, United States

    MANSFIELD, TX 760633208

    Phone: (817) 477-5271

    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 2025-12-31 (164 days ago).

Enrollment records

1

Earliest due date

2025-12-31

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
O20100930088764OPharmacyTX2025-12-31

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 count42458$0
90480Admn sarscov2 vacc 1 dose7979$0
91322Sarscov2 vac 50 mcg/0.5ml im7979$0
G0008Administration of influenza virus vaccine7878$0
90662Influenza vaccine split virus, preservative free4040$0
View full utilization report →

Insurance plans in this area (ZIP 61834)

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Reviews

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Frequently asked questions

Can I verify WALGREENS #05213 with an NPI only?
You can start verification with NPI 1679588644 for WALGREENS #05213, then check state licensing separately.
Can I rely on WALGREENS #05213 being an active provider?
As of the registry snapshot, WALGREENS #05213 is marked active.
What is WALGREENS #05213 best known for clinically?
Directory data describes WALGREENS #05213 with Pharmacy. Clinical services aligned with this taxonomy classification.
Where should I expect WALGREENS #05213 on a map?
Expect Danville, Illinois as a primary anchor for WALGREENS #05213 unless the record lists multiple sites.
Why does WALGREENS #05213 have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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