Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shopko Stores Operating Co LLC

Organization Durable Medical Equipment & Medical Supplies · NPI 1083887012

Shopko Stores Operating Co LLC is a Durable Medical Equipment & Medical Supplies in Dwight, Illinois. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

110 Watters Dr
Dwight, IL 60420-2200
Phone: (815) 584-3330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1083887012
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Bettiga — Executive Vice President & Coo · (920) 429-4297
Other names Shopko Pharmacy 641
NPI enumeratedApril 10, 2008
Last updated in NPPESSeptember 28, 2012
Mailing address110 Watters Dr, Dwight, IL 60420-2200

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