IndividualActive
Cassidy Domagalla
NPI 1386222685 · Geriatric Pharmacist · Peoria, IL
Provider details
- NPI number
- 1386222685
- Entity type
- Individual
- Primary specialty
- Geriatric PharmacistPharmacy Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 051.296273 (IL)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
126 Oak St
Peoria, IL 61602-1639
Phone: (309) 690-7790
Fax: (866) 385-4948
Approximate (ZIP-level) locationGet directions
Mailing address
817 Normal Ave
Normal, IL 61761-1531
Registry dates
- Enumerated
- 2021-03-30
- Last updated
- 2021-03-30
- Certified
- 2021-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.