Individual provider Active NPI

John Paul Evans, RPH, MS

  • Pharmacist
  • Freeport, IL
National Provider Identifier
1295015949
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051029978 Issued in IL
Practice address
1732 S West Ave
Freeport, IL 61032-6710
Phone
(815) 235-8148
Fax
(815) 235-8634
NPI assigned
Aug 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051029978 IL Primary

Addresses

Primary practice location

1732 S West Ave
Freeport, IL 61032-6710

Mailing address

1732 S West Ave
Freeport, IL 61032-6710
Phone (815) 235-8148

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
Master of Science, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051029978ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1295015949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 S WEST AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326710",
            "telephone_number": "815-235-8148",
            "fax_number": "815-235-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 S WEST AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326710",
            "telephone_number": "815-235-8148",
            "fax_number": "815-235-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "RPH, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051029978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.