Organization · Type 2 NPI

Dolan Central Illinois Compounding LLC

Compounding Pharmacy · Peoria, IL

NPI number 1093883290 Active

Practice location

5832 N Knoxville Ave Ste E
Peoria, IL 61614-4304

Call (309) 679-2047 Map

Fax (309) 679-2051

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	054.020600 (IL)
Community/Retail Pharmacy	3336C0003X	2099-43 (WI)
Compounding Pharmacy Primary	3336C0004X	4394 (IA)

Compounding Pharmacy: A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compoun…

Another provider at this address

Dolan Central Illinois Compounding Pharmacy LLCPharmacist Peoria, IL NPI 1568970556

NPI record

NPI: 1093883290
Entity type: Organization (Type 2)
Issued: Dec 4, 2006
Last updated: Sep 19, 2025
Status: Active

Other names

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Preckshot Professional Pharmacy · doing business as
Preckshot Professional Pharmacy · doing business as

Authorized official

Corey Dolan
Pharmacist
(309) 679-2047

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093883290

Dolan Central Illinois Compounding LLC's National Provider Identifier is 1093883290, issued on Dec 4, 2006. The primary taxonomy on file is Compounding Pharmacy (3336C0004X), and the practice location is in Peoria, IL. The record was last updated on Sep 19, 2025.