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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