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General NPI Number Information
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NPI Number | 1609885474
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Entity Type | Individual
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Provider Name | DAVID S LEADER MD
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 1877 W DOWNER PL
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City | AURORA
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State | IL
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Zip | 60506-7302
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Country | US
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Telephone | 630-906-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 W GALENA BLVD
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City | AURORA
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State | IL
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Zip | 60506-4356
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Country | US
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Telephone | 630-859-6700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-067126
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License Number State | IL
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