Provider Demographics
NPI:1831533439
Name:CHAMPER, LEON ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:ROBERT
Last Name:CHAMPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 S NAPER BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8300
Mailing Address - Country:US
Mailing Address - Phone:630-369-4844
Mailing Address - Fax:630-369-4879
Practice Address - Street 1:1259 S NAPER BLVD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8300
Practice Address - Country:US
Practice Address - Phone:630-369-4844
Practice Address - Fax:630-369-4879
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.021614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist