Active NPI
Glenna Katrina Hagan, PHARM.D.
- Pharmacist
- Chillicothe, IL
National Provider Identifier
1609413202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051.290593
- Practice address
- 603 S 4TH St
Chillicothe, IL 61523-2267 - Phone
- (309) 274-6419
- Fax
- (309) 274-2506
- NPI assigned
- Dec 3, 2019
- Last updated
- Dec 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 051.290593 | IL | Primary |
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
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 |
|---|---|---|---|
| 051.290593 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575331200000",
"number": "1609413202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3327 W KING JAMES RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616152589",
"telephone_number": "309-922-9541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 S 4TH ST",
"city": "CHILLICOTHE",
"state": "IL",
"postal_code": "615232267",
"telephone_number": "309-274-6419",
"fax_number": "309-274-2506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGAN",
"first_name": "GLENNA",
"middle_name": "KATRINA",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-03",
"last_updated": "2019-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.290593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, IL
- First Community Care, LLC
- Timothy James Freund, DDS
- Jacqueline Gill, PT, DPT
- Amanda Giltner, MS CCC-SLP/L
- Crystal Carin Hackett, MFT
- Heritage Manor Chillicothe, LLC (Heritage Health)
- Heritage Manor Chillicothe, LLC (Heritage Health - Chillicothe)
- Amanda M Hewerdine
- Highland Park CVS, L.L.C. (CVS Pharmacy # 06450)
- Kate Joann Holler
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.