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Prescriber Registration

Eligibility Information

You must have a valid DEA Number or Controlled Substance License Number to register for the ILPMP.

Are you a prescriber with an Illinois Professional License?
Yes No

Do you have a DEA Number?
Yes No

Do you have a Controlled Substance License?
Yes No

Do you have a NPI Number?
Yes No

Are you a DATA Waivered Prescriber?
Yes No

Personal Information

Please provide your personal information.

First Name *

Last Name *

Email *

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

Confirm Email *