Provider Demographics
NPI:1659421246
Name:LEONARD, RICHARD B (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:B
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:650 SPRING HILL RING RD
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1296
Mailing Address - Country:US
Mailing Address - Phone:847-426-0227
Mailing Address - Fax:847-426-0299
Practice Address - Street 1:650 SPRING HILL RING RD
Practice Address - Street 2:SUITE 2020
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1296
Practice Address - Country:US
Practice Address - Phone:847-426-0227
Practice Address - Fax:847-426-0299
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36-038356207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC37534Medicare UPIN