Active NPI
Jack Leya, MD
- Gastroenterology Physician
- Maywood, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036066173
- Practice address
- 2160 S First Ave
(Fahey BLDG., RM. 007)
Maywood, IL 60153 - Phone
- (708) 216-3307
- Fax
- (708) 216-4113
- NPI assigned
- Jan 13, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036066173 | IL | |
| Gastroenterology Physician | 207RG0100X | 036066173 | IL | Primary |
Addresses
Primary practice location
2160 S First Ave
(Fahey BLDG., RM. 007)
Maywood, IL 60153
Mailing address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-3307
Other practice location 1
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 2
1036 W Stephenson St
Freeport, IL 61032-4865
Phone (815) 599-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36066173 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jleya12437@direct.luhs.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372
Hospital & facility affiliations
- FHN Memorial Hospital
- Loyola University Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 85 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 103 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36066173 | IL | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freeport Regional Health Care Foundation | Internal Medicine | Current | Accepting new patients |
| Freeport Memorial Hospital | Current | Accepting new patients |
Locations
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
1036 W Stephenson St
Freeport, IL 61032
Phone (815) 599-7410
600 N Rush St
Stockton, IL 61085
Phone (815) 235-3165
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Freeport, IL
- NPI 1457337016
Internal Medicine
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- General Acute Care Hospital
- Freeport, IL
- NPI 1447228788
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Freeport, IL
- NPI 1447228788
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1336128602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "708-216-3307",
"fax_number": "708-216-4113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"address_2": "(FAHEY BLDG., RM. 007)",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-3307",
"fax_number": "708-216-4113"
}
],
"practiceLocations": [
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"fax_number": "815-599-7974",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1036 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324865",
"country_code": "US",
"telephone_number": "815-599-6000",
"fax_number": "815-599-7974",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEYA",
"first_name": "JACK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036066173",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036066173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36066173",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jleya12437@direct.luhs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2160 S First Ave",
"address_2": "(Fahey BLDG., rm. 007)",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "60153",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.