Provider Demographics
NPI:1083633663
Name:PIAZZA, LEONARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:S
Last Name:PIAZZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W MARTIN AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6547
Mailing Address - Country:US
Mailing Address - Phone:630-355-5668
Mailing Address - Fax:630-355-2071
Practice Address - Street 1:10 W MARTIN AVE STE 260
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6547
Practice Address - Country:US
Practice Address - Phone:630-355-5668
Practice Address - Fax:630-355-2071
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL764360Medicare ID - Type Unspecified
ILC48694Medicare UPIN