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NPI Code Detail

MEDICARE: JULIE A LEISCHNER MD

MEDICARE: JULIE A LEISCHNER MD
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
1207R00000XInternal Medicine Physician336066264IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1084920OTHERSIHO - NICC
2000000509791OTHERANTHEM - NICC

General Provider Information

NPI Number : 1336222488
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE A LEISCHNER MD
Provider Business Mailing Address
First Line : 111 N COUNTY FARM RD
Second Line :
City : WHEATON
State : IL
Zip : 60187-3988
Country : US
Telephone Number : 630-682-7400
Fax Number :
Provider Business Practice Location Address
First Line : 111 N COUNTY FARM RD
Second Line :
City : WHEATON
State : IL
Zip : 60187-3988
Country : US
Telephone Number : 630-682-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 04/29/2024

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