Jack Leong, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036070436 Issued in IL

Practice address

3000 N Cicero Ave
Chicago, IL 60641-5106

Phone

(773) 282-3115

Fax

(773) 282-0590

NPI assigned

Nov 21, 2005

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: General Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exclusive Physicians - Illinois PLLCGroup PAC ID 5496256067, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Humboldt Park Health Hospital, Chicago, IL, CCN 140206
• Community First Medical Center Hospital, Chicago, IL, CCN 140251

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.leong.1@33060.direct.athenahealth.com
• Direct secure messaging: jleongmd@cpc.azalea.phimailbox.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Exclusive Physicians - Illinois PLLC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1346055365
  Medicare reassignment Care Compare group NPD
• Jack C Leong MD SC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1437357480
  Medicare reassignment NPD Authorized official
• Jack C. Leong MD SC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1013448448
  Authorized official Same address or phone

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community First Healthcare of Illinois, Inc

  dba Community First Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033214416
  Care Compare affiliation
• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877
  Care Compare affiliation

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1174506513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415106",
            "telephone_number": "773-282-3115",
            "fax_number": "773-282-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415106",
            "telephone_number": "773-282-3115",
            "fax_number": "773-282-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036070436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jleongmd@cpc.azalea.phimailbox.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3000 N Cicero Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606415106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Leonardis, DC
• Caroline Larkin Leonczyk, PHD
• Anngela Leone
• Anna Leong, RPH
• Danielle F Leong, O.D.
• King Swee Leong, MD
• Lisa Leong
• Nicole Leong
• Barrett Leonhard
• Christoph Harald Leonhard, PH.D.

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.

Verify at the official NPI Registry.