Individual
BERNARD LEASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
173309
WI
207L00000X
Anesthesiology Physician
209023941
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209023941
IL
Other
Enumeration date
08/22/2019
Last updated
06/01/2022
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