Individual
OVIDIO A DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
912 S WOOD ST, NPI-S ROOM 830, MC 913, CHICAGO, IL 60612-4300
(312) 996-3584
(312) 413-7856
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036087657
IL
Other
Enumeration date
09/20/2006
Last updated
03/30/2009
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