Organization Active NPI

Leonard Cerullo, MD, LTD

  • Interventional Pain Medicine Physician
  • Chicago, IL
National Provider Identifier
1164940813
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
LEONARD CERULLO, MD, LTD
Practice address
680 N Lake Shore Dr Ste 1428
Chicago, IL 60611-3461
Phone
(312) 442-0431
NPI assigned
Sep 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leonard Cerullo, MD
Title
President
Phone
(312) 442-0431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

680 N Lake Shore Dr Ste 1428
Chicago, IL 60611-3461

Mailing address

680 N Lake Shore Dr Ste 1428
Chicago, IL 60611-3461
Phone (312) 442-0431

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1164940813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1428",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113461",
            "telephone_number": "312-442-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1428",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113461",
            "telephone_number": "312-442-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD CERULLO, MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CERULLO",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-442-0431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.