Individual
LESLIE FENIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-7761
(312) 864-9314
Mailing address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-7761
(312) 864-9314
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008154
IL
Other
Enumeration date
01/25/2021
Last updated
05/01/2023
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