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Active NPI 1790790913 Organization (Entity Type 2) Subpart Facility

Walgreen Co

Pharmacy • Lyons, IL

Parent Organization: Walgreens Holding Company

About Walgreen Co NPI 1790790913 Summary

Walgreen Co is a verified healthcare organization specializing in Pharmacy operating in Lyons, IL. Located at 4101 1ST AVE, this facility provides patient care and medical services under National Provider Identifier (NPI) 1790790913.

Walgreen Co operates as a subpart facility of Walgreens Holding Company. Administrative operations and authorized compliance are overseen by Jennifer Ponce (Manager).

The facility is associated with 11 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

4101 1st Ave

Lyons, IL 605341028

Telephone 7084476851
Fax 7084470568

Authorized Official Information

Authorized Contact Name

Jennifer Ponce

Title / Role

Manager

Official Telephone

8475272489

Facility Classifications & Specialties

Pharmacy Primary Taxonomy

NUCC Taxonomy Code: 333600000X

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Durable Medical Equipment & Medical Supplies

NUCC Taxonomy Code: 332B00000X

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Pharmacy - Community/Retail Pharmacy

NUCC Taxonomy Code: 3336C0003X

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

11 Linked
Molly Netter NPI 1194259069

Nurse Practitioner - Family

Lyons, IL

View Practitioner Profile →
Lauren Frigo NPI 1275817363

Pharmacist

Lyons, IL

View Practitioner Profile →
Laura Kukulski NPI 1285101550

Nurse Practitioner

Lyons, IL

View Practitioner Profile →

Nurse Practitioner - Family

Lyons, IL

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events
📍
Updated Business Mailing Address July 21, 2026

Registered at 1901 E VOORHEES ST, MS 790, DANVILLE, IL 618344515 (Tel: 8475272489)

NPI Profile Active August 31, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 31, 2015

Registered at 4101 1ST AVE, LYONS, IL 605341028 (Tel: 7084476851)

📍
Updated Business Mailing Address August 31, 2015

Registered at 1901 E VOORHEES ST, MS 790, DANVILLE, IL 618344509 (Tel: 2177092386)

🏛️
Organization / Clinic Name Updated August 31, 2015

Operating as WALGREEN CO

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 31, 2015

Durable Medical Equipment & Medical Supplies

🟢
Initial NPI Registration & Enumeration July 29, 2006

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1790790913
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: July 29, 2006
Last Update: July 21, 2026

Mailing Address

1901 E Voorhees St, Ms 790

Danville, IL 618344515

Phone: 8475272489

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.