Individual
KENNETH C LEEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
19624 GOVERNORS HWY, FLOSSMOOR, IL 60422-2077
(708) 798-5838
(708) 798-5865
Mailing address
23654 SPRINGS CT UNIT 119, PLAINFIELD, IL 60585-2243
(630) 567-2132
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041395579
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209013780
IL
Other
Enumeration date
01/20/2016
Last updated
07/21/2022
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