MEDICARE: AMANDA LEYH APN-CNP

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	363LA2200X	Adult Health Nurse Practitioner	0024185871	VA
2	363L00000X	Nurse Practitioner	209030027	IL

General Provider Information

NPI Number	:	1366158453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LEYH APN-CNP

Provider Business Mailing Address
First Line	:	100 SPALDING DR STE 110
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6551
Country	:	US
Telephone Number	:	443-745-0452
Fax Number	:

Provider Business Practice Location Address
First Line	:	24600 W 127TH ST BLDG A
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-9508
Country	:	US
Telephone Number	:	331-221-9004
Fax Number	:	630-548-3260

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

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	04/10/2026

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