MEDICARE: DR. CHRISTOPH HARALD LEONHARD PH.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	103TB0200X	Cognitive & Behavioral Psychologist		IL

General Provider Information

NPI Number	:	1760507750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPH HARALD LEONHARD PH.D.

Provider Business Mailing Address
First Line	:	557 FRANKLIN AVE
Second Line	:
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-1719
Country	:	US
Telephone Number	:	312-329-6614
Fax Number	:	312-644-3333

Provider Business Practice Location Address
First Line	:	325 N WELLS ST
Second Line	:	SUITE 431
City	:	CHICAGO
State	:	IL
Zip	:	60610-4705
Country	:	US
Telephone Number	:	312-329-6614
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/08/2007

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