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Organization
DOLAN CENTRAL ILLINOIS COMPOUNDING LLC
Active
Organization
DOLAN CENTRAL ILLINOIS COMPOUNDING LLC
Active
Other names
Preckshot Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
COREY DOLAN (PHARMACIST)
(309) 679-2047
Entity
Organization
Contact information
Practice address
5832 N KNOXVILLE AVE STE E, PEORIA, IL 61614-4304
(309) 679-2047
(309) 679-2051
Mailing address
5832 N KNOXVILLE AVE STE E, PEORIA, IL 61614-4304
(309) 679-2047
(309) 679-2051
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
054.020600
IL
3336C0003X
Community/Retail Pharmacy
2099-43
WI
3336C0004X
Compounding Pharmacy
Primary
4394
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175601
PK
—
Enumeration date
12/04/2006
Last updated
09/19/2025
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