Individual
DR. LEOPOLDO S. PARDO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1667 GOLF COURSE DR, BELLEVILLE, IL 62220-4824
(618) 257-8017
(618) 257-8017
Mailing address
1667 GOLF COURSE DR, BELLEVILLE, IL 62220-4824
(618) 257-8017
(618) 257-8017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036087011
IL
208M00000X
Hospitalist Physician
036087011
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087011
—
IL
05
—
1114913274
—
IL
Enumeration date
09/23/2005
Last updated
04/06/2020
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