Carl Alexander-Mutter Leonard

Primary specialty

DentistTaxonomy code 122300000X

License

019027364 Issued in IL

Practice address

434 W Ontario St Ste 300
Chicago, IL 60654

Phone

(312) 475-9751

NPI assigned

Oct 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Revolution Dental

  • Dental Clinic/Center
  • Schaumburg, IL
  • NPI 1932671708
  NPD (past) Authorized official
• Procare Dental Group, P.C.

  • Dentist
  • Chicago, IL
  • NPI 1528246212
  NPD (past)

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1508054586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 IDA PL",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600221913",
            "telephone_number": "312-498-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 W ONTARIO ST STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "312-475-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "CARL",
        "middle_name": "ALEXANDER-MUTTER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Rose Leon, OTR
• Leonard Cerullo, MD, LTD
• Leonard D Elkun MD SC
• Leonard R. Jubert
• Leonard Stallings MD & Associates
• Christopher John Leonard, D.D.S
• Daniel Christopher Leonard, D.D.S.
• Elizabeth Ann Leonard, PT
• Emily A Leonard, DPT
• Eugene T Leonard IV, DDS

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.