Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 125.071604 | IL |
NPI | 1003347394 |
---|---|
Provider Name | Stephen Leb |
First Address | Chicago, IL 60611-2311 |
Second Address | Chicago, IL 60611-3167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2017 |
Last Update Date | 18/11/2018 |