Healthcare Provider Details

I. General information

NPI: 1962403659
Provider Name (Legal Business Name): LEONARD FEINKIND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 05/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 W 15TH ST 3RD FLOOR
CHICAGO IL
60608-1610
US

IV. Provider business mailing address

2720 W 15TH ST 3RD FLOOR
CHICAGO IL
60608-1610
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-6676
  • Fax: 773-257-4785
Mailing address:
  • Phone: 773-257-6676
  • Fax: 773-257-4785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number036-080099
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: