Provider Demographics
NPI:1619951340
Name:MILLMAN, LEONARD J (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:J
Last Name:MILLMAN
Suffix:
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 1:720 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1852
Mailing Address - Country:US
Mailing Address - Phone:847-382-3640
Mailing Address - Fax:847-382-3692
Practice Address - Street 1:720 FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1852
Practice Address - Country:US
Practice Address - Phone:847-382-3640
Practice Address - Fax:847-382-3692
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36051282207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
L84581Medicare ID - Type Unspecified
D12053Medicare UPIN