Pharmacist Registration

Eligibility Information

Do you have an Illinois Professional License?
Yes No

Do you have a NPI Number?
Yes No

Are you a clinical pharmacist associated with Medicaid Managed Care Organization (MCO) in Illinois?
Yes No

You must have an Illinois professional license to be associated with a Managed Care Organization.

Please provide your personal information.

First Name *

Last Name *

Email *

It is recommended to use an email address that is not associated with your pharmacy or current employer, as this will be used for account recovery.

Confirm Email *