Provider Demographics
NPI:1649355504
Name:LEONE, ANTONIO SALVATORE (DC)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:SALVATORE
Last Name:LEONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-1744
Mailing Address - Country:US
Mailing Address - Phone:217-384-8180
Mailing Address - Fax:217-384-8186
Practice Address - Street 1:909 N CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-1744
Practice Address - Country:US
Practice Address - Phone:217-384-8180
Practice Address - Fax:217-384-8186
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38010048111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation