Individual
MS. LEANNE H DENEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
28 VETERAN'S DRIVE, HARRISBURG, IL 62946
(618) 993-0404
(618) 993-1717
Mailing address
3412 OFFICE PARK DRIVE, MARION, IL 62959
(618) 993-0404
(618) 993-1717
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
085000461
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085000461
—
IL
Enumeration date
12/11/2006
Last updated
05/23/2019
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