Individual provider Active NPI

Lisa Gandhi, PHARM.D.

  • Pharmacist
  • Peoria Heights, IL
National Provider Identifier
1528336245
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051292147 Issued in IL
Practice address
1200 E War Memorial Dr
Peoria Heights, IL 61616-7723
Phone
(309) 682-6844
NPI assigned
Dec 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 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 051292147 IL Primary

Addresses

Primary practice location

1200 E War Memorial Dr
Peoria Heights, IL 61616-7723

Mailing address

10013 North Brompton Drive
Peoria, IL 61615
Phone (630) 795-9258

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
051292147ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1528336245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10013 NORTH BROMPTON DRIVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "630-795-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WAR MEMORIAL DR",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167723",
            "telephone_number": "309-682-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "LISA",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051292147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.