Taylor Grove

Individual provider Active NPI Pharmacist · Danville, IL

NPI 1003772203 · NPPES record last updated Dec 31, 2025

Key facts

NPI
1003772203
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PHA-PHA-LIC-108156 (MT)
Practice address
1900 E Main St
Danville, IL 61832-5100
Phone
(217) 554-4747
NPI assigned
Dec 31, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PHA-PHA-LIC-108156MTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA-PHA-LIC-108156 MT Yes

Addresses

Primary practice location

1900 E Main St
Danville, IL 61832-5100

Mailing address

1900 E Main St
Danville, IL 61832-5100

Other providers in Danville, IL

All providers in Danville, IL · Pharmacist in Illinois

Sources for this page

Verify at the official NPI Registry.