Dolan Central Illinois Compounding LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

4394 Issued in IA

Legal business name

DOLAN CENTRAL ILLINOIS COMPOUNDING LLC

Practice address

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

Phone

(309) 679-2047

Fax

(309) 679-2051

NPI assigned

Dec 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Corey Dolan

Title

Pharmacist

Phone

(309) 679-2047

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Preckshot Professional Pharmacy Doing business as

Tax ID family

Dolan Central Illinois Compounding LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dolan Central Illinois Compounding Pharmacy LLC

  • Pharmacist
  • Peoria, IL
  • NPI 1568970556
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1093883290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5832 N KNOXVILLE AVE STE E",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144304",
            "telephone_number": "309-679-2047",
            "fax_number": "309-679-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 N KNOXVILLE AVE STE E",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144304",
            "telephone_number": "309-679-2047",
            "fax_number": "309-679-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOLAN CENTRAL ILLINOIS COMPOUNDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "309-679-2047"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054.020600",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "2099-43",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IA",
            "license": "4394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175601",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preckshot Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Preckshot Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sherry Marie Dockins, LCPC
• Karen Rae Dodd, L.C.S.W.
• Jenny R. Doering
• Morgan Doerr
• Paige Doherty
• Dolan Central Illinois Compounding Pharmacy LLC
• Shannon Dolan
• Tonia Dolan
• Pamela Doloszycki, APN
• Cassidy Louise Domagalla

• Compounding Pharmacy in Peoria, IL
• Providers in Peoria, IL by specialty
• Compounding Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.