Individual
LESLIE S MCILVRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1755 PARK ST, SUITE #300, NAPERVILLE, IL 60563-4861
(630) 416-6056
Mailing address
706 STEEPLECHASE RD, SAINT CHARLES, IL 60174-4705
(508) 631-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
242197
MA
363LF0000X
Family Nurse Practitioner
Primary
242197
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0367630
—
MA
01
—
C434
HARVARD PILGRIM
MA
01
—
NP3266
BLUE CROSS
MA
Enumeration date
03/23/2006
Last updated
09/14/2016
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