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Individual

ANDREIA LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8658 S COTTAGE GROVE AVE, UNIT 400, CHICAGO, IL 60619-6186
(773) 723-1270
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015342
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619908
BCBS IL GROUP NUMBER
IL
01
1623066
BCBS PROVIDER #
IL
01
367885100
US DEPT OF LABOR PROV #
IL
01
567700
MEDICARE GROUP NUMBER
IL
01
568080
MEDICARE GROUP NUMBER
IL
01
568150
MEDICARE GROUP NUMBER
IL
01
CJ4383
R.R. MEDICARE GRP #
IL
Enumeration date
09/29/2006
Last updated
04/06/2015
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