Individual
MRS. LINDA KATHLEEN LEAFGREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-2323
(309) 344-4368
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-2323
(309) 344-4368
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-139242
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041-139242
IL
171M00000X
Case Manager/Care Coordinator
041-139242
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-139242
DPR
IL
01
—
370984175
FEIN BWAY ORG
IL
Enumeration date
03/27/2007
Last updated
09/14/2009
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