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General NPI Number Information
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NPI Number | 1801555818
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Entity Type | Individual
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Provider Name | DARLENE LEUNG NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 12/17/2021
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE # 51
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 312-227-3550
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Fax | 312-227-9642
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Provider Business Mailing Address
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Address Line | 225 EAST CHICAGO AVENUE BOX 51
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 773-519-2897
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209024906
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License Number State | IL
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