| Leonard Stallings Md & Associates | |
|
5120 W Jackson Blvd Chicago IL 60644-4332 | |
| (773) 265-4566 | |
| (773) 265-4576 |
| Full Name | Leonard Stallings Md & Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 5120 W Jackson Blvd, Chicago, Illinois |
| Authorized Official Name and Position | Leonard Stallings (PRESIDENT) |
| Authorized Official Contact | 7732654566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonard Stallings Md & Associates Po Box 5128 River Forest IL 60305 Ph: (773) 265-4639 | Leonard Stallings Md & Associates 5120 W Jackson Blvd Chicago IL 60644-4332 Ph: (773) 265-4566 |
| NPI Number | 1053481176 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 05/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053481176 | NPI | - | NPPES |
| 036071417 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036071417 (Illinois) | Primary |
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