MEDICARE: LESLIE GABLE, M.D., S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1427028661	OTHER	IL	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1013046465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESLIE GABLE, M.D., S.C.

Provider Business Mailing Address
First Line	:	180 N MICHIGAN AVE
Second Line	:	SUITE 2411
City	:	CHICAGO
State	:	IL
Zip	:	60601-7401
Country	:	US
Telephone Number	:	312-263-5114
Fax Number	:	773-244-6380

Provider Business Practice Location Address
First Line	:	180 N MICHIGAN AVE
Second Line	:	SUITE 2411
City	:	CHICAGO
State	:	IL
Zip	:	60601-7401
Country	:	US
Telephone Number	:	312-263-5114
Fax Number	:	773-244-6380

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LESLIE GABLE
Credential	:
Telephone Number	:	312-263-5114

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	08/22/2020

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Directions to “LESLIE GABLE, M.D., S.C. ” Practice Location

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