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General NPI Number Information
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NPI Number | 1649632118
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Entity Type | Individual
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Provider Name | LEO THOMAS GOZDECKI DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE STE MC6080
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City | CHICAGO
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State | IL
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Zip | 60637-1641
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Country | US
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Telephone | 773-702-5211
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Fax | 773-702-8875
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Provider Business Mailing Address
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Address Line | 150 HARVESTER DR STE 300
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City | BURR RIDGE
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State | IL
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Zip | 60527-5965
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Country | US
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Telephone |
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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 | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 02007880A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 036.149522
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License Number State | IL
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