Organization
THE LEASENBY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY LEASENBY (PRACTICE MANAGER)
(630) 851-9222
Entity
Organization
Contact information
Practice address
4260 WESTBROOK DRIVE., SUITE 106, AURORA, IL 60504
(630) 851-9222
(630) 851-9281
Mailing address
4260 WESTBROOK DRIVE., SUITE 106, AURORA, IL 60504
(630) 851-9222
(630) 851-9281
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04522643
BLUE CROSS BLUE SHIELD
IL
01
—
2562855
AETNA HEALTHCARE
IL
01
—
7182229
AETNA HEALTHCARE NON HMO
IL
Enumeration date
01/16/2007
Last updated
09/10/2007
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