Provider Demographics
NPI:1225634322
Name:LANTZ, JANIE LEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANIE
Middle Name:LEA
Last Name:LANTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JANIE
Other - Middle Name:LEA
Other - Last Name:WELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4604 TRINITY LAKES DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-4412
Mailing Address - Country:US
Mailing Address - Phone:217-430-0058
Mailing Address - Fax:
Practice Address - Street 1:1400 HARRISON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-6706
Practice Address - Country:US
Practice Address - Phone:217-222-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.302366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist