Healthcare Provider Details

I. General information

NPI: 1306779889
Provider Name (Legal Business Name): MEGAN UNDERWOOD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N WOOD SAGE RD
PEORIA IL
61615-7822
US

IV. Provider business mailing address

145 TUSCANY CT
MORTON IL
61550-7804
US

V. Phone/Fax

Practice location:
  • Phone: 309-243-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number051.302338
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: