Healthcare Provider Details

I. General information

NPI: 1932235314
Provider Name (Legal Business Name): JOAN H LESKA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E WACKER DRIVE SUITE 1350
CHICAGO IL
60601
US

IV. Provider business mailing address

35 E WACKER DRIVE SUITE 1350
CHICAGO IL
60601
US

V. Phone/Fax

Practice location:
  • Phone: 312-553-9898
  • Fax: 312-553-4213
Mailing address:
  • Phone: 312-553-9898
  • Fax: 312-553-4213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: