Individual provider Active NPI

Leeland Goodheart, PHARM D

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1609151265
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.291549 Issued in IL
Practice address
4040 N Cicero Ave
Chicago, IL 60641-1807
Phone
(773) 283-5321
NPI assigned
Oct 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 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 051.291549 IL Primary

Addresses

Primary practice location

4040 N Cicero Ave
Chicago, IL 60641-1807

Mailing address

4040 N Cicero Ave
Chicago, IL 60641-1807
Phone (773) 283-5321

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
051.291549ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1609151265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411807",
            "telephone_number": "773-283-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411807",
            "telephone_number": "773-283-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODHEART",
        "first_name": "LEELAND",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.291549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.