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Individual

DR. MICHAEL LEAHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
10001 W 143RD ST, ORLAND PARK, IL 60462-2026
(708) 349-2600
(708) 349-2600
Mailing address
10001 W 143RD ST, ORLAND PARK, IL 60462-2026
(708) 349-2600
(708) 349-2600

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046007442
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0363241858
TAX ID OAK LAWN
IL
01
0363448367
TAX ID ORLAND PARK
IL
01
0410017674
RR MEDICARE IND ORLAND PK
IL
01
0410022638
RR MEDICARE IND. OAK LAWN
IL
01
0618250001
DME
IL
01
1148260001
DME/OP
IL
01
508980
MEDICARE GROUP OL
IL
01
985800
MEDICARE GROUP/ OP
IL
01
CN3870
RR MEDICARE GROUP NUMBER
IL
01
DA8522
RR MEDICARE GROUP OP
IL
01
T365669
UPIN/ OL GROUP
IL
01
W22602
UPIN/GROUP OP
IL
Enumeration date
05/12/2006
Last updated
02/21/2008
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