Individual
LESLIE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, APN
Contact information
Practice address
2418 W DIVISION ST, CHICAGO, IL 60622-2940
(312) 666-3494
(312) 666-6228
Mailing address
2018 W BRADLEY PL, CHICAGO, IL 60618-4908
(773) 244-0509
(773) 244-0510
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
209002127
IL
367A00000X
Advanced Practice Midwife
Primary
209-002127
IL
Other
Enumeration date
09/28/2006
Last updated
08/09/2021
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