MEDICARE: LEONARD DUBIN MD LLC

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	207R00000X	Internal Medicine Physician	036104972	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558667451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEONARD DUBIN MD LLC

Provider Business Mailing Address
First Line	:	675 W NORTH AVE STE 401
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1624
Country	:	US
Telephone Number	:	708-632-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 W NORTH AVE STE 401
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1624
Country	:	US
Telephone Number	:	708-632-5566
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. LEONARD DUBIN
Credential	:	MD
Telephone Number	:	708-632-5566

Provider Enumeration Date	:	02/10/2011
Last Update Date	:	04/17/2025

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