Organization Active NPI

Leonard Dubin MD LLC

  • Internal Medicine Physician
  • Melrose Park, IL
National Provider Identifier
1558667451
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036104972 Issued in IL
Legal business name
LEONARD DUBIN MD LLC
Practice address
675 W North Ave Ste 401
Melrose Park, IL 60160-1624
Phone
(708) 632-5566
NPI assigned
Feb 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Dr. Leonard Dubin, MDNPI 1518976737
Title
Member
Phone
(708) 632-5566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036104972 IL Primary

Addresses

Primary practice location

675 W North Ave Ste 401
Melrose Park, IL 60160-1624

Mailing address

675 W North Ave Ste 401
Melrose Park, IL 60160-1624
Phone (708) 632-5566

Other practice location 1

3340 Dundee Rd Ste 2N2
Northbrook, IL 60062-2332
Phone (847) 454-0301

Other identifiers 1

IdentifierTypeStateIssuer
036104972MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110421000083 IL Part B Supplier - Clinic/Group Practice 0941485775 Receives reassigned benefits from 1 practitioner
Practice locations: Northbrook, IL; Melrose Park, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0994331Leonard Dubin MD LLC675 W North Ave, Ste 401, Melrose Park, IL 60160Provider-performed microscopyJul 12, 2028
14D1002730Leonard Dubin MD L L C3340 Dundee Rd - Ste 2N2, Northbrook, IL 60062Certificate of waiverAug 13, 2026

National Provider Directory

National Provider Directory

Locations

675 W North Ave
Ste 401
Melrose Park, IL 60160
Phone (708) 632-5566

3340 Dundee Rd
Ste 2N2
Northbrook, IL 60062
Phone (847) 454-0301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1558667451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE STE 401",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601624",
            "telephone_number": "708-632-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE STE 401",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601624",
            "telephone_number": "708-632-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Dundee Rd Ste 2N2",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622332",
            "country_code": "US",
            "telephone_number": "847-454-0301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEONARD DUBIN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "DUBIN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "708-632-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036104972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104972",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.