Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A124051 | CA |
N | 207X00000X | Orthopaedic Surgeon | PENDING | MD |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036142609 | IL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | PENDING | MD |
NPI | 1114217411 |
---|---|
Provider Name | Natalie L Leong |
First Address | Chicago, IL 60602-4885 |
Second Address | Chicago, IL 60612-4861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 07/04/2018 |