Individual provider Active NPI

David Leehey, MD

  • Nephrology Physician
  • Maywood, IL
National Provider Identifier
1689651580
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
36056027 Issued in IL
Practice address
2160 S First Ave
(Luh - North ENT., RM. 7604)
Maywood, IL 60153
Phone
(708) 216-3306
Fax
(708) 216-1259
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 36056027 IL Primary

Addresses

Primary practice location

2160 S First Ave
(Luh - North ENT., RM. 7604)
Maywood, IL 60153

Mailing address

2160 S First Ave
(Luh - North ENT., RM. 7604)
Maywood, IL 60153
Phone (708) 216-3306

Other identifiers 1

IdentifierTypeStateIssuer
36056027MedicaidIL

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
I20050811000171 IL Practitioner - NephrologyPractitioner - Internal Medicine 3870522782

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Boston University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36056027ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Rm 7604
Maywood, IL 60153
Phone (708) 216-3304

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

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 3

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1689651580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(LUH - NORTH ENT., RM. 7604)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-3306",
            "fax_number": "708-216-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(LUH - NORTH ENT., RM. 7604)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-3306",
            "fax_number": "708-216-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEHEY",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "36056027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36056027",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.