Provider Demographics
NPI:1770503120
Name:G. LEONE, M.D., S.C.
Entity Type:Organization
Organization Name:G. LEONE, M.D., S.C.
Other - Org Name:LEONE DERMATOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIULIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-394-1320
Mailing Address - Street 1:3060 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1530
Mailing Address - Country:US
Mailing Address - Phone:847-394-1320
Mailing Address - Fax:847-394-3674
Practice Address - Street 1:3060 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1530
Practice Address - Country:US
Practice Address - Phone:847-394-1320
Practice Address - Fax:847-394-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036039808207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCA4621OtherRAILROAD MEDICARE GROUP
ILCE1299OtherRAILROAD MEDICARE GROUP
ILCE1299OtherRAILROAD MEDICARE GROUP
IL906720Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER