Active NPI
Christine Katherine Licina, PHARMD
- Pharmacist
- Marion, IL
National Provider Identifier
1134400724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-039350
- Practice address
- 1704 W Deyoung St
Marion, IL 62959-1054 - Phone
- (618) 993-6330
- NPI assigned
- Sep 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-039350 | IL | Primary |
Addresses
Primary practice location
1704 W Deyoung St
Marion, IL 62959-1054
Mailing address
202 Carlisle CT
Oswego, IL 60543-7531
Phone (630) 551-4157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-039350 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past | Accepting new patients | |
| TLC Immunization Clinic LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
-
- Family Nurse Practitioner
- Louisville, KY
- NPI 1982620050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777075200000",
"number": "1134400724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CARLISLE CT",
"city": "OSWEGO",
"state": "IL",
"postal_code": "605437531",
"telephone_number": "630-551-4157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 W DEYOUNG ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591054",
"telephone_number": "618-993-6330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICINA",
"first_name": "CHRISTINE",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-08",
"last_updated": "2026-04-25",
"certification_date": "2026-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-039350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.