Glenna Katrina Hagan, PHARM.D.
Individual provider Active NPI Pharmacist · Chillicothe, IL
NPI 1609413202 · NPPES record last updated Dec 3, 2019
Key facts
- NPI
- 1609413202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051.290593 (IL)
- Practice address
- 603 S 4TH St
Chillicothe, IL 61523-2267 - Phone
- (309) 274-6419
- Fax
- (309) 274-2506
- NPI assigned
- Dec 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.290593 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.290593 | IL | Yes |
Addresses
Primary practice location
603 S 4TH St
Chillicothe, IL 61523-2267
Mailing address
3327 W King James Rd
Peoria, IL 61615-2589
Phone (309) 922-9541
Other providers in Chillicothe, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.