OrganizationActive
Shopko Stores Operating Co LLC
NPI 1083887012 · Community/Retail Pharmacy · Dwight, IL
Shopko Stores Operating Co LLC is a Community/Retail Pharmacy organization in Dwight, IL (NPI 1083887012).
Provider details
- NPI number
- 1083887012
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Bettiga, Executive Vice President & Coo(920) 429-4297
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
110 Watters Dr
Dwight, IL 60420-2200
Phone: (815) 584-3330
Street-level locationGet directions
Mailing address
110 Watters Dr
Dwight, IL 60420-2200
Other names (DBA / former)
- Doing business as
- Shopko Pharmacy 641
Registry dates
- Enumerated
- 2008-04-10
- Last updated
- 2012-09-28
Frequently asked questions
- What is Shopko Stores Operating Co LLC's NPI number?
- Shopko Stores Operating Co LLC's National Provider Identifier (NPI) is 1083887012, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shopko Stores Operating Co LLC?
- Shopko Stores Operating Co LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Shopko Stores Operating Co LLC located?
- Shopko Stores Operating Co LLC's practice location on file with NPPES is 110 Watters Dr, Dwight, IL 60420-2200.
- What is Shopko Stores Operating Co LLC's phone number?
- The practice phone number listed in the NPPES registry for Shopko Stores Operating Co LLC is (815) 584-3330.
- Who is the authorized official for Shopko Stores Operating Co LLC?
- The authorized official listed on Shopko Stores Operating Co LLC's NPPES record is Michael Bettiga, Executive Vice President & Coo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shopko Stores Operating Co LLC's NPI active?
- Yes — Shopko Stores Operating Co LLC's NPI (1083887012) is active in the NPPES registry as of the last update on 2012-09-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.