Provider Demographics
NPI:1255624060
Name:LEONARD, CHRISTINE (DC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 N PERRYVILLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6225
Mailing Address - Country:US
Mailing Address - Phone:815-977-5480
Mailing Address - Fax:815-977-3479
Practice Address - Street 1:695 N PERRYVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6225
Practice Address - Country:US
Practice Address - Phone:815-977-5480
Practice Address - Fax:815-977-3479
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor