Organization
LEONARD R. JUBERT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD R JUBERT (OWNER/PODIATRIST)
(773) 776-9400
Entity
Organization
Contact information
Practice address
8054 S WESTERN AVE, CHICAGO, IL 60620-5936
(773) 776-9400
(773) 776-9644
Mailing address
8054 S WESTERN AVE, CHICAGO, IL 60620-5936
(773) 776-9400
(773) 776-9644
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60001709
BLUE CROSS BLUE SHIELD ID
IL
Enumeration date
02/07/2008
Last updated
02/08/2008
Update your record
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