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Individual

DR. ANDREY LEONOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 514-2712
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-2000

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036-125826
IL
208000000X
Pediatrics Physician
248493
NY
208000000X
Pediatrics Physician
25MA08039700
NJ
208000000X
Pediatrics Physician
35089736
OH
2080P0201X
Pediatric Allergy/Immunology Physician
4301107932
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2745373
OH
Enumeration date
09/25/2006
Last updated
08/10/2023
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