MEDICARE: DR. JOAN MARY LEYA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician		IL
2	207VG0400X	Gynecology Physician		IL

General Provider Information

NPI Number	:	1326037912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN MARY LEYA M.D.

Provider Business Mailing Address
First Line	:	800 AUSTIN ST
Second Line	:	SUITE 310 WEST TOWER
City	:	EVANSTON
State	:	IL
Zip	:	60202-3439
Country	:	US
Telephone Number	:	847-475-5188
Fax Number	:	847-475-8778

Provider Business Practice Location Address
First Line	:	800 AUSTIN ST
Second Line	:	SUITE 310 WEST TOWER
City	:	EVANSTON
State	:	IL
Zip	:	60202-3439
Country	:	US
Telephone Number	:	847-475-5188
Fax Number	:	847-475-8778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	09/11/2025

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