MEDICARE: LEO G. NIEDERMAN M.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	208000000X	Pediatrics Physician	036061069	IL

General Provider Information

NPI Number	:	1801806351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEO G. NIEDERMAN M.D.

Provider Business Mailing Address
First Line	:	1653 W CONGRESS PKWY
Second Line	:	770 JONES
City	:	CHICAGO
State	:	IL
Zip	:	60612-3833
Country	:	US
Telephone Number	:	312-942-1501
Fax Number	:	312-563-4159

Provider Business Practice Location Address
First Line	:	1653 W CONGRESS PKWY
Second Line	:	770 JONES
City	:	CHICAGO
State	:	IL
Zip	:	60612-3244
Country	:	US
Telephone Number	:	312-942-1501
Fax Number	:	312-563-4159

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	09/21/2011

Similar Medicare Providers

1679688246 — DR. IVONNE HERAS HOBFOLL PH.D.
Practice Location Address:

1653 W CONGRESS PARKWAY , RUSH UNIVERSITY MEDICAL CENTER-DEPT. BEHAVIORAL SCIENCE
CHICAGO, IL
60612-3244

Practice Phone: 312-942-5932
Practice Fax: 312-942-4990

1043433600 — PAMELA G CIANCI APN
Practice Location Address:

1725 W HARRISON ST , SUITE 1156
CHICAGO, IL
60612-3244

Practice Phone: 312-942-5458
Practice Fax: 311-942-3666

1598172397 — DR. ALYSON KAY ZALTA PH.D.
Practice Location Address:

1645 W JACKSON BLVD STE 400
CHICAGO, IL
60612-3244

Practice Phone: 312-563-2828
Practice Fax: 312-942-4990

1871084897 — DR. TERESA LILLIS PHD
Practice Location Address:

1645 W JACKSON BLVD STE 400
CHICAGO, IL
60612-3244

Practice Phone: 312-942-6011
Practice Fax:

1700449659 — CHRISTINA SOUV KHOU PHD
Practice Location Address:

1645 W JACKSON BLVD STE 400
CHICAGO, IL
60612-3244

Practice Phone: 312-942-5932
Practice Fax: 312-942-4990

1255994075 — AVIVA ARIEL-DONGES PHD, MPH
Practice Location Address:

1645 W JACKSON BLVD STE 400
CHICAGO, IL
60612-3244

Practice Phone: 312-942-5932
Practice Fax: 312-942-4990

Directions to “ LEO G. NIEDERMAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.