Individual provider Active NPI

Jonathan M Lehan, PHARM.D

  • Pharmacist
  • Rockford, IL
National Provider Identifier
1518025972
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.290036 Issued in IL
Practice address
811 S Perryville Rd Unit 109
Rockford, IL 61108-4323
Phone
(779) 423-0542
Fax
(779) 545-2277
NPI assigned
Dec 5, 2006
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.290036 IL Primary

Addresses

Primary practice location

811 S Perryville Rd Unit 109
Rockford, IL 61108-4323

Mailing address

1850 Gateway Dr
Suite a
Sycamore, IL 60178-3192
Phone (815) 217-3890

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
051.290036ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Compounding Pharmacy LLC Current Accepting new patients

Locations

811 S Perryville Rd
Unit 109
Rockford, IL 61108
Phone (779) 423-0542

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1518025972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "address_2": "SUITE A",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-217-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S PERRYVILLE RD UNIT 109",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611084323",
            "telephone_number": "779-423-0542",
            "fax_number": "779-545-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHAN",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.290036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.