Provider Demographics
NPI:1326032871
Name:VEKKOS, LEONARD E (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:E
Last Name:VEKKOS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3540 SEVEN BRIDGES DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1221
Mailing Address - Country:US
Mailing Address - Phone:630-852-8522
Mailing Address - Fax:630-852-8556
Practice Address - Street 1:3540 SEVEN BRIDGES DR
Practice Address - Street 2:SUITE 290
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1221
Practice Address - Country:US
Practice Address - Phone:630-852-8522
Practice Address - Fax:630-852-8556
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-003413213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK00489OtherPIN NUMBER
ILK00489OtherPIN NUMBER
IL270040493OtherTAX ID NUMBER