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General NPI Number Information
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NPI Number | 1619057106
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Entity Type | Individual
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Provider Name | BONNIE L. LESHUK
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 2300 N CHILDRENS PLZ 46
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City | CHICAGO
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State | IL
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Zip | 60614-3363
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Country | US
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Telephone | 773-327-1022
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Fax | 773-327-1054
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Provider Business Mailing Address
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Address Line | 2300 N CHILDRENS PLZ 46
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City | CHICAGO
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State | IL
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Zip | 60614-3363
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Country | US
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Telephone | 773-327-1022
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Fax | 773-327-1054
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 056.002207
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | 213000202
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License Number State | IL
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