Provider Demographics
NPI:1326037912
Name:LEYA, JOAN MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARY
Last Name:LEYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:LEYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:SUITE 310 WEST TOWER
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-475-5188
Mailing Address - Fax:847-475-8778
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 310 WEST TOWER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-475-5188
Practice Address - Fax:847-475-8778
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207VE0102X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology