Active NPI
Andrey Leonov, M.D.
- Allergy & Immunology Physician
- Joliet, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 036-125826
- Practice address
- 2100 Glenwood Ave
Joliet, IL 60435-5487 - Phone
- (815) 514-2712
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 248493 | NY | |
| Pediatrics Physician | 208000000X | 35089736 | OH | |
| Pediatrics Physician | 208000000X | 25MA08039700 | NJ | |
| Pediatric Allergy/Immunology Physician | 2080P0201X | 4301107932 | MI | |
| Allergy & Immunology Physician | 207K00000X | 036-125826 | IL | Primary |
Addresses
Primary practice location
2100 Glenwood Ave
Joliet, IL 60435-5487
Mailing address
PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2745373 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aleonov178312@direct.edward.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-125826 | IL | MD | Allergy & Immunology Physician |
| 25MA08039700 | NJ | MD | Pediatrics Physician |
| 248493 | NY | MD | Pediatrics Physician |
| 4301107932 | MI | MD | Pediatric Allergy/Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dupage Medical Group LTD | Current | Accepting new patients | |
| Dupage Medical Group LTD | Current | Accepting new patients | |
| Michigan State University Kalamazoo Center for Medical Studies | Past | Accepting new patients |
Locations
30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210
1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000
2100 Glenwood Ave
Joliet, IL 60435
Phone (815) 999-3201
301 Madison St
Ste 207
Joliet, IL 60435
Interoperability endpoints
- aleonov178312@dulyhealthandcare.direct-ci.com
- aleonov178312@direct.edward.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Downers Grove, IL
- NPI 1801833983
-
- Durable Medical Equipment & Medical Supplies
- Glen Ellyn, IL
- NPI 1760979447
-
- Multi-Specialty Clinic/Center
- Kalamazoo, MI
- NPI 1568467249
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1043310261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 713260",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606771260",
"telephone_number": "630-469-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 GLENWOOD AVE",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355487",
"telephone_number": "815-514-2712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONOV",
"first_name": "ANDREY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "248493",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35089736",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA08039700",
"primary": false
},
{
"code": "2080P0201X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Allergy/Immunology",
"state": "MI",
"license": "4301107932",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "IL",
"license": "036-125826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2745373",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aleonov178312@direct.edward.org",
"affiliation": "N",
"address_1": "2100 Glenwood Ave",
"city": "Joliet",
"state": "IL",
"country_code": "US",
"postal_code": "604355487",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.