Leslie A Dean, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036090988 Issued in IL

Practice address

1511 N Blackhawk Blvd
Univ Primary Care Clinic @ Rockton
Rockton, IL 61072-1513

Phone

(815) 624-2644

Fax

(815) 624-2186

NPI assigned

Feb 22, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Leslie A Johnson Former name

Medicare fee-for-service enrollment

Enrolled in IL, SC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leslie.dean.1@21400.direct.athenahealth.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.

• Saint James Hospital

  dba Saint James Hospital - Multiple Hospital Departments

  • Anesthesiology Physician
  • Pontiac, IL
  • NPI 1790735421
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Centerwell Senior Primary Care SC JV PC

  dba CenterWell Senior Primary Care-Cayce

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1962101501

  Family Medicine

  Medicare reassignment NPD
• Board of Trustees of the University of Illinois

  dba University Medical Services at Parkview

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1003218348
  NPD
• Saint James Hospital

  dba OSF Healthcare - Medical Group - Roanoke

  • Rural Health Clinic/Center
  • Roanoke, IL
  • NPI 1164138848
  NPD
• Saint James Hospital

  dba OSF Healthcare - Medical Group (Non-RHC Billing)

  • Family Medicine Physician
  • Clinton, IL
  • NPI 1356058119
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• Centerwell Senior Primary Care SC JV PC

  dba CenterWell Senior Primary Care -North Augusta

  • Internal Medicine Physician
  • North Augusta, SC
  • NPI 1508671132

  Family Medicine

  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1316912462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PARKVIEW AVE",
            "address_2": "CREDENTIALING S200",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071822",
            "telephone_number": "815-395-5861",
            "fax_number": "815-395-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 N BLACKHAWK BLVD",
            "address_2": "UNIV PRIMARY CARE CLINIC @ ROCKTON",
            "city": "ROCKTON",
            "state": "IL",
            "postal_code": "610721513",
            "telephone_number": "815-624-2644",
            "fax_number": "815-624-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "336052592",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036090988",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "JOHNSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie J Carlson, DPT
• Tyler R Carroll, DPT
• Denise Clouser
• Connections Therapy Center PLLC
• Ronald Glenn Conrad I, PTA
• Lisa Degennaro, COTA
• Laura Elizabeth Easton
• Carole J Eatock, CNP
• Scott Ege, P.T.
• Leslie Jane Eggers, CCC-SLP

• Family Medicine Physician in Rockton, IL
• Providers in Rockton, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.