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Individual
MICHELLE LEONG
Active
Individual
MICHELLE LEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036160713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036160713
STATE LICENSE
IL
Enumeration date
04/09/2017
Last updated
05/08/2024
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