Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | IL | |
N | 207VG0400X | Gynecologist | IL |
NPI | 1326037912 |
---|---|
Provider Name | Dr. Joan Mary Leya |
First Address | Evanston, IL 60202-3439 |
Second Address | Evanston, IL 60202-3439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 08/07/2007 |