Healthcare Provider Details

I. General information

NPI: 1861403172
Provider Name (Legal Business Name): METROPOLITAN DIAGNOSTIC IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE SUITE 620
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

111 N WABASH AVE SUITE 620
CHICAGO IL
60602-1903
US

V. Phone/Fax

Practice location:
  • Phone: 312-807-3555
  • Fax: 312-807-3922
Mailing address:
  • Phone: 312-807-3555
  • Fax: 312-807-3922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number1272106
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1272106
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number1272106
License Number StateIL

VIII. Authorized Official

Name: DR. JOEL E LELAND
Title or Position: PRESIDENT MEDICAL DIRECTOR
Credential: DO
Phone: 312-807-3555