Individual provider Active NPI

John O'Dwyer Jr., R.PH.

  • Nutrition Support Pharmacist
  • Aurora, IL
National Provider Identifier
1114068624
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support PharmacistTaxonomy code 1835N1003X
License
34730 Issued in IL
Practice address
157 S Lincoln Ave
Aurora, IL 60505-4264
Phone
(630) 240-2019
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 34730 IL
Nutrition Support Pharmacist 1835N1003X 34730 IL Primary
Pharmacotherapy Pharmacist 1835P1200X 34730 IL

Addresses

Primary practice location

157 S Lincoln Ave
Aurora, IL 60505-4264

Mailing address

157 S Lincoln Ave
Aurora, IL 60505-4264
Phone (630) 240-2019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
34730ILMDNutrition Support Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Medical Apothecary, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114068624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 S LINCOLN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605054264",
            "telephone_number": "630-240-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 S LINCOLN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605054264",
            "telephone_number": "630-240-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DWYER",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "34730",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "IL",
            "license": "34730",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": "34730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.