Leddell, Courtney

Leddell, Courtney is an individual health care provider with primary practice located at 1300 Franklin Ave , Normal IL 61761-3592. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Leddell, Courtney can be contacted via phone (309) 454-1400.

Contact Information

Primary practice address
1300 Franklin Ave Normal IL 61761-3592
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036114585 Illinois

Profile Details

NPI number 1962508523
LBN Legal business name Leddell, Courtney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jun 16th, 2022 - about 2 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 1962508523 NPPES
Illinois MEDICAID 036114585

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