IndividualActive
Justin Mckinnie
NPI 1154923084 · Pharmacist · Mattoon, IL
Provider details
- NPI number
- 1154923084
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 051292076 (IL)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
101 Dettro Dr
Mattoon, IL 61938-9044
Phone: (217) 258-6313
Street-level locationGet directions
Mailing address
9854 N County Road 000e
Mattoon, IL 61938-6505
Registry dates
- Enumerated
- 2020-11-16
- Last updated
- 2020-11-16
- Certified
- 2020-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.