Active NPI
Ovidio A De Leon, M.D.
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1164520474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036087657
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7232 - Phone
- (866) 600-2273
- NPI assigned
- Sep 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036087657 | IL | Primary |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7232
Mailing address
912 S Wood St
Npi-S Room 830, MC 913
Chicago, IL 60612-4300
Phone (312) 996-3584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036087657 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238371200000",
"number": "1164520474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 S WOOD ST",
"address_2": "NPI-S ROOM 830, MC 913",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124300",
"telephone_number": "312-996-3584",
"fax_number": "312-413-7856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "866-600-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "OVIDIO",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2009-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036087657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.