Leazzo, Anthony S

Leazzo, Anthony S is an individual health care provider with primary practice located at 2425 Fargo Blvd , Geneva IL 60134-3591. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Leazzo, Anthony S can be contacted via phone (630) 232-2200.

Contact Information

Primary practice address
2425 Fargo Blvd Geneva IL 60134-3591
Fax: (630) 232-1940
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036111542 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036111542 Illinois

Profile Details

NPI number 1912056995
LBN Legal business name Leazzo, Anthony S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Dec 20th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912056995 NPPES
Illinois MEDICAID 036111542
Illinois Other P00433169

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