Organization
JACK C. LEONG MD SC
Active
Parent organization
CICERO PROMPT CARE AND FAMILY MEDICAL CENTER
Other names
Jack C. Leong MD SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CICERO PROMPT CARE AND FAMILY MEDICAL CENTER
Authorized official
DR. JACK C LEONG (M.D, S.C.)
(773) 282-3115
Entity
Organization
Contact information
Practice address
3000 N CICERO AVE, CHICAGO, IL 60641-5106
(773) 231-2885
Mailing address
3000 N CICERO AVE, CHICAGO, IL 60641-5106
(773) 231-2885
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
036070436
IL
207Q00000X
Family Medicine Physician
Primary
036070436
IL
261QP2300X
Primary Care Clinic/Center
336034323
IL
302R00000X
Health Maintenance Organization
336034323
IL
305R00000X
Preferred Provider Organization
336034323
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070436
—
IL
Enumeration date
03/27/2017
Last updated
10/20/2020
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