MEDICARE: KATHERINE LEONARDIS DC

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	111N00000X	Chiropractor	038013248	IL

General Provider Information

NPI Number	:	1740745652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE LEONARDIS DC

Provider Business Mailing Address
First Line	:	2625 BUTTERFIELD RD STE 301N
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1266
Country	:	US
Telephone Number	:	630-468-1824
Fax Number	:

Provider Business Practice Location Address
First Line	:	3132 N SHEFFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-9024
Country	:	US
Telephone Number	:	773-938-0566
Fax Number	:

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

Provider Enumeration Date	:	02/05/2019
Last Update Date	:	06/24/2019

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Directions to “ KATHERINE LEONARDIS DC” Practice Location

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