Individual
LEO HALL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVE, (17W740 22ND STREET, OAKBROOK TERRACE, IL 60181), MAYWOOD, IL 60153
(630) 627-7399
(630) 627-7079
Mailing address
2160 S FIRST AVE, (17W740 22ND STREET, OAKBROOK TERRACE, IL 60181), MAYWOOD, IL 60153
(630) 627-7399
(630) 627-7079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36070077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36070077
—
IL
Enumeration date
02/15/2006
Last updated
06/29/2021
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