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1093827685
KEVIN ALAN LEISEBERG
MARENGO, IL
NPI
1093827685
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070-011208)
Enumeration Date
2006-08-31
Last Update Date
2016-04-21
Business Address
-- KEVIN ALAN LEISEBERG MS, PT
300 S STATE ST
MARENGO, IL 60152-3532
Phone number: 815-568-4550
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Mailing Address
-- KEVIN ALAN LEISEBERG MS, PT
625 ENTERPRISE DR
OAK BROOK, IL 60523-8813
Phone number: 630-575-1980
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