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Individual

DR. EDWARD LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2300 N EDWARD ST, EMERGENCY DEPT, DECATUR, IL 62526-4163
(217) 876-3000
Mailing address
2300 N EDWARD ST, EMERGENCY DEPT, DECATUR, IL 62526-4163
(217) 876-3000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0361409383
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036109383
BCILLINOIS
05
036109383001
IL
05
1582965
IA
01
225150
IHS
01
93334
BCWELLMARK 7TH
01
93378
BCWELLMARK WEST
01
IL0181
JOHN DEERE ILLINOIS
01
P00053389
RR MEDICARE
Enumeration date
02/17/2006
Last updated
11/17/2012
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