Individual provider Active NPI

Linda Marie Sewell Wilson, RPH, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Peoria, IL
National Provider Identifier
1457573305
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
051290140 Issued in IL
Practice address
801 W Lake Ave Ste 1a
Peoria, IL 61614-5995
Phone
(309) 682-2983
Fax
(309) 682-3128
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051290140 IL Primary
Pharmacist 183500000X 051290140 IL

Addresses

Primary practice location

801 W Lake Ave Ste 1a
Peoria, IL 61614-5995

Mailing address

801 W Lake Ave Ste 1a
Peoria, IL 61614-5995
Phone (309) 682-2983

Other names 1

  • Linda Marie Sewell Wilson Professional name

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051290140ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1457573305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W LAKE AVE STE 1A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145995",
            "telephone_number": "309-682-2983",
            "fax_number": "309-682-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W LAKE AVE STE 1A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145995",
            "telephone_number": "309-682-2983",
            "fax_number": "309-682-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEWELL WILSON",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051290140",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051290140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "SEWELL WILSON",
            "middle_name": "MARIE",
            "credential": "PHARM D, RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; 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.