Leonard, Mary Beth
Leonard, Mary Beth is an individual health care provider with primary practice located at 3245 Grove Ave , Berwyn IL 60402-3474. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Leonard, Mary Beth can be contacted via phone (708) 484-0621.Contact Information
Primary practice address
3245 Grove Ave
Berwyn IL 60402-3474
Phone: (708) 484-0621
Fax: (708) 484-0250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036-079983 | Illinois |
Profile Details
| NPI number | 1063402048 |
|---|---|
| LBN Legal business name | Leonard, Mary Beth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Mar 9th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063402048 | NPPES |
| Other | 01619787 | BCBSIL GROUP NUMBER | |
| MEDICAID | 036079983 | BCBSIL GROUP NUMBER |
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