Healthcare Provider Details

I. General information

NPI: 1558685081
Provider Name (Legal Business Name): CARA R LEPPELLERE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA RAQUEL ZIMMERMAN M.D.

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
GALENA IL
61036-8118
US

IV. Provider business mailing address

1 MEDICAL CENTER DR
GALENA IL
61036-8118
US

V. Phone/Fax

Practice location:
  • Phone: 815-776-7381
  • Fax: 815-776-7385
Mailing address:
  • Phone: 815-776-7381
  • Fax: 825-776-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number41517
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: