Healthcare Provider Details

I. General information

NPI: 1881686715
Provider Name (Legal Business Name): PHILIP LEUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 129TH INFANTRY DR SUITE 400
JOLIET IL
60435-3171
US

IV. Provider business mailing address

903 129TH INFANTRY DR SUITE 400
JOLIET IL
60435-3171
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-2653
  • Fax: 815-744-3232
Mailing address:
  • Phone: 815-725-2653
  • Fax: 815-744-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036-084773
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036-084773
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036084773
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036084773
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: