Individual provider Active NPI

Timothy Alan Leich, RPH

  • Pharmacist
  • Clinton, IL
National Provider Identifier
1689942724
Registry record updated Dec 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051286344 Issued in IL
Practice address
424 W Van Buren St
Clinton, IL 61727-2130
Phone
(217) 935-1357
Fax
(217) 935-5952
NPI assigned
Dec 4, 2011
Last updated
Dec 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 051286344 IL Primary

Addresses

Primary practice location

424 W Van Buren St
Clinton, IL 61727-2130

Mailing address

424 W Van Buren St
Clinton, IL 61727-2130
Phone (217) 935-1357

Other identifiers 1

IdentifierTypeStateIssuer
051286344OtherILPHARMACIST LICENSE

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051286344ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1322956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322956800000",
    "number": "1689942724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W VAN BUREN ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272130",
            "telephone_number": "217-935-1357",
            "fax_number": "217-935-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W VAN BUREN ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272130",
            "telephone_number": "217-935-1357",
            "fax_number": "217-935-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICH",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-04",
        "last_updated": "2011-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051286344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "051286344",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.