Individual provider Active NPI

James Lee Lazzari Jr., RPH

  • Pharmacist
  • Peoria, IL
National Provider Identifier
1831471564
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051037348 Issued in IL
Practice address
4814 N Sheridan Rd
Peoria, IL 61614-5928
Phone
(309) 688-6752
Fax
(309) 688-7106
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 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 051037348 IL Primary

Addresses

Primary practice location

4814 N Sheridan Rd
Peoria, IL 61614-5928

Mailing address

5408 W Rachael Dr
Peoria, IL 61615-3017
Phone (309) 693-0861

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
051037348ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1831471564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 W RACHAEL DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153017",
            "telephone_number": "309-693-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4814 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145928",
            "telephone_number": "309-688-6752",
            "fax_number": "309-688-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZZARI",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051037348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 20, 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.