Healthcare Provider Details

I. General information

NPI: 1366361925
Provider Name (Legal Business Name): TARA CLAYPOOL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N ALLEN ST
ROBINSON IL
62454-1090
US

IV. Provider business mailing address

1300 N ALLEN ST
ROBINSON IL
62454-1090
US

V. Phone/Fax

Practice location:
  • Phone: 618-544-2167
  • Fax: 618-544-9298
Mailing address:
  • Phone: 618-544-2167
  • Fax: 618-544-9298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051293528
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: