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General NPI Number Information
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NPI Number | 1992856876
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Entity Type | Organization
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Legal Business Name | THE LEASENBY CLINIC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 4260 WESTBROOK DRIVE. SUITE 106
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City | AURORA
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State | IL
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Zip | 60504
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Country | US
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Telephone | 630-851-9222
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Fax | 630-851-9281
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Provider Business Mailing Address
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Address Line | 4260 WESTBROOK DRIVE. SUITE 106
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City | AURORA
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State | IL
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Zip | 60504
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Country | US
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Telephone | 630-851-9222
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Fax | 630-851-9281
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. KIMBERLY LEASENBY
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Credential |
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Telephone | 630-851-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0900X
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Taxonomy Name | Internist Chiropractor
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License Number |
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License Number State | IL
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