| NPI | 1013448448 |
|---|---|
| Doing Business As | JACK C. LEONG MD SC |
| Entity Type | Organization |
| Authorized Contact | JACK C LEONG M.D, S.C. 773-282-3115 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036070436) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 036070436) |
| 261QP2300X Clinic/Center, Primary Care (Licence: IL 336034323) | |
| 302R00000X Health Maintenance Organization (Licence: IL 336034323) | |
| 305R00000X Preferred Provider Organization (Licence: IL 336034323) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-10-20 |