Individual provider Active NPI

Leslie Spencer, MD

  • Gynecology Physician
  • Hinsdale, IL
National Provider Identifier
1316051097
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
03691693 Issued in IL
Practice address
40 S Clay St # 100
Hinsdale, IL 60521-3257
Phone
(630) 920-2229
Fax
(630) 920-8342
NPI assigned
Aug 18, 2006
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 03691693 IL Primary

Addresses

Primary practice location

40 S Clay St # 100
Hinsdale, IL 60521-3257

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018

Other identifiers 2

IdentifierTypeStateIssuer
P00631958OtherILRR MEDICARE
036091693MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lspencer3565@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080821000491 IL Practitioner - Obstetrics/Gynecology 6507945557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03691693ILMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jun 1, 2008 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 1, 2008 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

40 S Clay St
#100
Hinsdale, IL 60521
Phone (630) 920-2229

40 S Clay St
Ste LL10
Hinsdale, IL 60521
Phone (630) 432-6848

908 N Elm St
Ste 300
Hinsdale, IL 60521
Phone (630) 455-1756

Interoperability endpoints

  • Direct secure messaging: lspencer3565@direct.edward.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1316051097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S CLAY ST # 100",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213257",
            "telephone_number": "630-920-2229",
            "fax_number": "630-920-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "03691693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00631958",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091693",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lspencer3565@direct.edward.org",
            "affiliation": "N",
            "address_1": "40 S Clay St # 100",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.