Individual
LESLEY ALTHEA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 E 51ST ST, CHICAGO, IL 60615-2400
(312) 572-2657
(312) 572-2595
Mailing address
711 S ASHLAND AVE, UNIT N, CHICAGO, IL 60607-3166
(312) 226-2665
(312) 226-2665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-082544
IL
207RI0200X
Infectious Disease Physician
Primary
036-082544
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-082544
STATE LICENSE NUMBER
IL
Enumeration date
07/22/2006
Last updated
04/10/2017
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