Provider Demographics
NPI:1346479102
Name:STROMBERG, LEROY III (MD)
Entity Type:Individual
Prefix:DR
First Name:LEROY
Middle Name:
Last Name:STROMBERG
Suffix:III
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 1:3249 OAK PARK AVE
Mailing Address - Street 2:MACNEAL HOSPITAL
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402
Mailing Address - Country:US
Mailing Address - Phone:708-783-3400
Mailing Address - Fax:708-783-3341
Practice Address - Street 1:3249 OAK PARK AVE
Practice Address - Street 2:MACNEAL HOSPITAL
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402
Practice Address - Country:US
Practice Address - Phone:708-783-3400
Practice Address - Fax:708-783-3341
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1348622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology