Organization
JACK C LEONG MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK C LEONG MD (MEDICAL DIRECTOR)
(773) 282-3115
Entity
Organization
Contact information
Practice address
3000 N CICERO AVE, CHICAGO, IL 60641-5106
(773) 282-3115
(773) 282-0590
Mailing address
3000 N CICERO AVE, CHICAGO, IL 60641-5106
(773) 282-3115
(773) 282-0590
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036070436
IL
Other
Enumeration date
07/10/2007
Last updated
10/20/2020
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