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NPI Code Detail

MEDICARE: DR. LESLIE J.M. BEAIRD M.D.

MEDICARE: DR. LESLIE J.M. BEAIRD M.D.
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
1207N00000XDermatology Physician036104353IL

General Provider Information

NPI Number : 1245259142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE J.M. BEAIRD M.D.
Provider Business Mailing Address
First Line : PO BOX 3376
Second Line :
City : BARRINGTON
State : IL
Zip : 60011-3376
Country : US
Telephone Number : 224-484-0183
Fax Number :
Provider Business Practice Location Address
First Line : 4885 HOFFMAN BLVD
Second Line : SUITE 407
City : HOFFMAN ESTATES
State : IL
Zip : 60192-3726
Country : US
Telephone Number : 224-484-0183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 08/03/2020

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