Provider Demographics
NPI:1336424068
Name:POON, LEIGHANNE SILVERIO (PHARMD)
Entity Type:Individual
Prefix:
First Name:LEIGHANNE
Middle Name:SILVERIO
Last Name:POON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LEIGHANNE
Other - Middle Name:
Other - Last Name:SILVERIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:16261 S BOULEVARD PL UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-4400
Mailing Address - Country:US
Mailing Address - Phone:815-676-1170
Mailing Address - Fax:
Practice Address - Street 1:16261 S BOULEVARD PL
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-4400
Practice Address - Country:US
Practice Address - Phone:815-676-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist