Healthcare Provider Details

I. General information

NPI: 1760507750
Provider Name (Legal Business Name): CHRISTOPH HARALD LEONHARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N WELLS ST SUITE 431
CHICAGO IL
60610-4705
US

IV. Provider business mailing address

557 FRANKLIN AVE
RIVER FOREST IL
60305-1719
US

V. Phone/Fax

Practice location:
  • Phone: 312-329-6614
  • Fax:
Mailing address:
  • Phone: 312-329-6614
  • Fax: 312-644-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: