Candice Marie Leach M.D.

NPI 1811124274 - General Practice - 208D00000X

NPI Details
NPI 1811124274
Gender Female
Enumeration Date 06/12/2009
Last Updated 09/17/2014
Entity Type Individual
Active Over 7 years ago
Practice Location
2160 S 1ST AVE
BLDG. 110-ROOM 3210
MAYWOOD IL, 60153-3328, US
Phone (708) 327-3436
Fax
Business Location
2160 S 1ST AVE
BLDG. 110-ROOM 3210
MAYWOOD IL, 60153-3328, US
Phone
Fax
Toxanomy
Taxonomy Code 208D00000X
License State Virginia
License Number 0101247933
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According to our database, Dr. Candice Marie Leach M.D. NPI is 1811124274, taxonomy code is 208D00000X and license number is 0101247933, license state is located at Virginia. Candice Marie Leach M.D. physically located at 2160 S 1st Ave, Maywood IL, 60153-3328. NPI Number Candice Marie Leach M.D. has the Individual type.

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1811124274 NPI number is provided on an as is basis without warranty of any kind. 1811124274 is maintained by the National Plan & Provider Enumeration System. The contents of Candice Marie Leach M.D. are for informational purposes only.