Individual
NICOLE M LEAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2003 W FULTON ST, CHICAGO, IL 60612-2345
(312) 243-2223
Mailing address
504 W 42ND PL, CHICAGO, IL 60609-2744
(773) 480-3244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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