=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548386956
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOHN LENO, M.D. S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 02/13/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 N COLLEGE AVE STE 210
-----------------------------------------------------
City | GENESEO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61254-1093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-944-0245
-----------------------------------------------------
Fax | 309-944-0541
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9821 27TH ST
-----------------------------------------------------
City | MILAN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61264-3515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-269-3280
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. JOHN HENRY LENO
-----------------------------------------------------
Credential | M.D. FACOG
-----------------------------------------------------
Telephone | 309-944-0245
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 36101226
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------