Individual
ROBERT LEYSAHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
10408 N CENTERWAY DR, PEORIA, IL 61615-1234
(309) 308-5100
Mailing address
313 MONTEREY DR, WASHINGTON, IL 61571-2946
(309) 256-9485
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020786
IL
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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