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General NPI Number Information
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NPI Number | 1306907316
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Entity Type | Organization
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Legal Business Name | LESLIE CHENG MD SC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 N HAVEN ROAD
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City | ELMHURST
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State | IL
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Zip | 60126-2923
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Country | US
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Telephone | 630-834-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 103 N HAVEN ROAD
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City | ELMHURST
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State | IL
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Zip | 60126-2923
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Country | US
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Telephone | 630-834-0990
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LESLIE CHENG
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Credential | MD
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Telephone | 630-834-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36052955
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License Number State | IL
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