Individual provider Active NPI

Margo Larissa Leatherwood, MD

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1548898604
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-166282 Issued in IL
Practice address
9550 W 167TH St Ste 200
Orland Park, IL 60467-5561
Phone
(708) 873-4500
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036-166282 IL Primary

Addresses

Primary practice location

9550 W 167TH St Ste 200
Orland Park, IL 60467-5561

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

9555 S 52nd Ave Ste F
Oak Lawn, IL 60453-3054
Phone (708) 422-5700

Other names 1

  • Margo Larissa Bailey Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mleatherwood296175@direct.myadvocateaurora.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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117001397 IL Practitioner - Family Practice 9537586474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

18210 S Lagrange Rd
200 Advocate Med Group
Tinley Park, IL 60487-7725
Phone (708) 479-6636

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

9550 W 167TH St
Orland Park, IL 60467-5561

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 11, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 11, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Ste F
Oak Lawn, IL 60453
Phone (708) 422-5700

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

9550 W 167th St
Ste 200
Orland Park, IL 60467
Phone (708) 873-4500

Interoperability endpoints

  • Direct secure messaging: mleatherwood296175@direct.myadvocateaurora.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1548898604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 W 167TH ST STE 200",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675561",
            "telephone_number": "708-873-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9555 S 52nd Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533054",
            "country_code": "US",
            "telephone_number": "708-422-5700",
            "fax_number": "708-422-8225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "MARGO",
        "middle_name": "LARISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-166282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9550 W 167th St Ste 200",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mleatherwood296175@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9550 W 167th St Ste 200",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARGO",
            "last_name": "BAILEY",
            "middle_name": "LARISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.