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Individual

DR. ORLY LEIVA JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5841 S MARYLAND AVE STE MC6080, CHICAGO, IL 60637-1641
(773) 702-9461
Mailing address
702 MASSACHUSETTS AVE APT 6, BOSTON, MA 02118-4054
(937) 602-9166

Taxonomy

Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
60719
KY
207RC0000X
Cardiovascular Disease Physician
60719
KY
207RI0011X
Interventional Cardiology Physician
Primary
60719
KY
390200000X
Student in an Organized Health Care Education/Training Program
036170231
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/11/2018
Last updated
03/03/2026
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