Provider Demographics
NPI:1578185591
Name:CHUGHTAI, LEENAH (MD)
Entity Type:Individual
Prefix:MS
First Name:LEENAH
Middle Name:
Last Name:CHUGHTAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E SIBLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2599
Mailing Address - Country:US
Mailing Address - Phone:708-340-7400
Mailing Address - Fax:708-340-7140
Practice Address - Street 1:600 E SIBLEY BLVD
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2599
Practice Address - Country:US
Practice Address - Phone:708-340-7400
Practice Address - Fax:708-340-7140
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2024-04-24
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-04-15
Provider Licenses
StateLicense IDTaxonomies
IL036169172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine