Provider Demographics
NPI:1780701680
Name:LESHCHINSKAYA, GALINA
Entity type:Individual
Prefix:
First Name:GALINA
Middle Name:
Last Name:LESHCHINSKAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 VENICE CT
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1730
Mailing Address - Country:US
Mailing Address - Phone:847-759-9534
Mailing Address - Fax:847-759-9534
Practice Address - Street 1:5441 N EAST RIVER RD UNIT 104
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1199
Practice Address - Country:US
Practice Address - Phone:773-444-2410
Practice Address - Fax:773-444-2410
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist