Individual
MATTHEW P LEISCHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVE, (LUH - NORTH ENT., RM 2601), MAYWOOD, IL 60153
(708) 216-5118
(708) 216-0814
Mailing address
2160 S FIRST AVE, (LUH - NORTH ENT., RM 2601), MAYWOOD, IL 60153
(708) 327-9152
(708) 216-0814
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
36104232
IL
208M00000X
Hospitalist Physician
Primary
036104232
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36104232
—
IL
Enumeration date
02/21/2006
Last updated
06/28/2021
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