Provider Demographics
NPI:1497115414
Name:LEAMY, DAN
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:LEAMY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N PLANKINTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-1802
Mailing Address - Country:US
Mailing Address - Phone:414-225-1573
Mailing Address - Fax:414-225-1575
Practice Address - Street 1:600 WILLIAMSON ST
Practice Address - Street 2:SUITE H
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3588
Practice Address - Country:US
Practice Address - Phone:608-252-6540
Practice Address - Fax:608-252-6559
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator