Test
Test
Extension
If you do not have a DEA Controlled substance license, please leave it blank and enter your Illinois Controlled Substance License Number below.
Illinois Controlled Substance License Number
Enter a Valid License Number
SecurityQ2Test
Security Question 3
Terms and Use Agreement
Terms and Use Agreement
Terms of Use must be agreed to in order to open a PMP account.
An error occured, please check your submission.
Illinois State License Number
Enter Valid License Number
That License Number has already been registered!
TestFName
TestLastName
TESTEMAIL
testConfirmEmail
Test
TestPassword
testConfirmPassword
Test
Phone Number
Extension
Enter Last 4 Digits of SSN
Enter Valid Practice Name Number
Business Address
Enter Valid Address
City
Enter Valid City
State
Enter Valid State
Zip Code
Enter Valid Zip Code
Enter Valid NPI Number
DEA Number
Enter Valid DEA Number
That DEA Number has already been registered!
Security Question 1
SecurityQ2Test
Security Question 3
Terms and Use Agreement
We will use the information to verify your identity and the authenticity of your access request. License status will be verified by using the applicable state's professional license lookup services. For verification purposes, all information is required and submitted information will remain confidential.
The use of the Prescription Inquiry Library (PMP) is intended for and may be only used for medical purposes.
I give the Prescription Monitoring Program and its representatives permission to contact me through the contact information I provided.
I understand that Illinois Law (720 ILCS 570/318) and US PL 104-191 prohibit the disclosure or discussion of any personal health information without proper written authorization.
I understand that I am personally responsible for all usage associated with this user ID.
I further understand that system usage is logged, and my access to the system may be denied or revoked at the discretion of the IDHS Bureau of Pharmacy and Clinical Support Services' Prescription Monitoring Unit.
Terms of Use must be agreed to in order to open a PMP account.
An error occured, please check your submission.
Illinois State License Number
Enter Valid License Number
That License Number has already been registered!
TestFName
TestLastName
TESTEMAIL
testConfirmEmail
Test
TestPassword
testConfirmPassword
Test
Phone Number
Extension
Enter Last 4 Digits of SSN
Enter Valid NPI Number
Practice Type
Enter Valid Practice Type
Enter Valid Practice Name
Business Address
Enter Valid Address
City
Enter Valid City
State
Enter Valid State
Zip Code
Enter Valid Zip Code
Security Question 1
SecurityQ2Test
Security Question 3
Terms and Use Agreement
We will use the information to verify your identity and the authenticity of your access request. License status will be verified by using the applicable state's professional license lookup services. For verification purposes, all information is required and submitted information will remain confidential.
The use of the Prescription Inquiry Library (PMP) is intended for and may be only used for medical purposes.
I give the Prescription Monitoring Program and its representatives permission to contact me through the contact information I provided.
I understand that Illinois Law (720 ILCS 570/318) and US PL 104-191 prohibit the disclosure or discussion of any personal health information without proper written authorization.
I understand that I am personally responsible for all usage associated with this user ID.
I further understand that system usage is logged, and my access to the system may be denied or revoked at the discretion of the IDHS Bureau of Pharmacy and Clinical Support Services' Prescription Monitoring Unit.
Terms of Use must be agreed to in order to open a PMP account.
An error occured, please check your submission.
Badge Number
Enter Valid License Number
TestFName
TestLastName
TESTEMAIL
testConfirmEmail
Test
TestPassword
testConfirmPassword
Test
Phone Number
Extension
Enter Last 4 Digits of SSN
Agency Name
Enter Valid Agency Name
Agency Address
Enter Valid Address
City
Enter Valid City
State
Enter Valid State
Zip Code
Enter Valid Zip Code
Security Question 1
SecurityQ2Test
Security Question 3
Terms and Use Agreement
We will use the information to verify your identity and the authenticity of your access request. License status will be verified by using the applicable state's professional license lookup services. For verification purposes, all information is required and submitted information will remain confidential.
The use of the Prescription Inquiry Library (PMP) is intended for and may be only used for medical purposes.
I give the Prescription Monitoring Program and its representatives permission to contact me through the contact information I provided.
I understand that Illinois Law (720 ILCS 570/318) and US PL 104-191 prohibit the disclosure or discussion of any personal health information without proper written authorization.
I understand that I am personally responsible for all usage associated with this user ID.
I further understand that system usage is logged, and my access to the system may be denied or revoked at the discretion of the IDHS Bureau of Pharmacy and Clinical Support Services' Prescription Monitoring Unit.
Terms of Use must be agreed to in order to open a PMP account.
An error occured, please check your submission.
Your Registration has been received!
You will receive an email at the address that was entered with details pertaining to your registration. Your registration may need to be reviewed based on the information entered. You will be contacted within 2 to 3 business days.
Thank you for registering with the Illinois Prescription Monitoring Program!