Individual provider Active NPI

Leslie Jay Block, MD

  • Pediatric Otolaryngology Physician
  • Lake Forest, IL
National Provider Identifier
1750300166
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
Practice address
700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679
Phone
(847) 295-1114
Fax
(847) 295-9373
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X IL Primary

Addresses

Primary practice location

700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679

Mailing address

700 N Westmoreland Rd
BLD F
Lake Forest, IL 60045-1679
Phone (847) 295-1114

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
I20101030000216 IL Practitioner - Otolaryngology 7810181161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Head and Neck Specialists S.C.Group PAC ID 3476640459, 8 clinicians

Practice addresses (Care Compare)

1880 W Winchester Rd
Suite 103
Libertyville, IL 60048-5321
Phone (847) 367-5770

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Head and Neck Specialists S.C. CurrentSince Jan 1, 2018 Accepting new patients

Locations

222 S Greenleaf St
Ste 102
Gurnee, IL 60031
Phone (847) 662-4442

1880 W Winchester Rd
Ste 103
Libertyville, IL 60048
Phone (847) 367-5770

Interoperability endpoints

  • Direct secure messaging: leslie.block.1@32683.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750300166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N WESTMORELAND RD",
            "address_2": "BLD F",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451679",
            "telephone_number": "847-295-1114",
            "fax_number": "847-295-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N WESTMORELAND RD",
            "address_2": "BLD F",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451679",
            "telephone_number": "847-295-1114",
            "fax_number": "847-295-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "LESLIE",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.