Individual provider Active NPI

Christian Leonard Lazaro-Marshall, PHARMD

  • Pharmacist
  • Crystal Lake, IL
National Provider Identifier
1215774575
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051306258 Issued in IL
Practice address
1305 Randall Rd
Crystal Lake, IL 60014-8601
Phone
(815) 356-0386
NPI assigned
Jul 12, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051306258 IL Primary

Addresses

Primary practice location

1305 Randall Rd
Crystal Lake, IL 60014-8601

Mailing address

147 Barry Rd
South Elgin, IL 60177-3132
Phone (630) 418-8499

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051306258ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1215774575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 BARRY RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773132",
            "telephone_number": "630-418-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 RANDALL RD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148601",
            "telephone_number": "815-356-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO-MARSHALL",
        "first_name": "CHRISTIAN",
        "middle_name": "LEONARD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051306258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.