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General NPI Number Information
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NPI Number | 1255484028
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Entity Type | Organization
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Legal Business Name | LEO G. PEPA, M.D.,LTD.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 2425 RPYAL BLVD SUITE 200
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City | ELGIN
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State | IL
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Zip | 60123-2507
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Country | US
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Telephone | 847-428-0400
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Fax | 847-428-0534
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Provider Business Mailing Address
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Address Line | 2425 ROYAL BLVD
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City | ELGIN
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State | IL
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Zip | 60123-2507
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Country | US
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Telephone | 847-428-0400
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Fax | 847-428-0534
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Authorized Official
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Title or Position | MGR
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Name | MRS. BERNICE K. DREVS
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Credential |
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Telephone | 847-428-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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