Individual provider Active NPI

Kathleen Anne Leinen, D.O.

  • Family Medicine Physician
  • Fairbury, IL
National Provider Identifier
1760630925
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036121354 Issued in IL
Practice address
106 S 1St St Ste 100
Fairbury, IL 61739-1509
Phone
(815) 692-2308
Fax
(815) 692-3278
NPI assigned
Aug 29, 2008
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036121354 IL Primary
Family Medicine Physician 207Q00000X N0919 TX

Addresses

Primary practice location

106 S 1St St Ste 100
Fairbury, IL 61739-1509

Mailing address

106 S 1St St Ste 100
Fairbury, IL 61739-1509
Phone (815) 692-2308

Other practice location 1

12602 Toepperwein Rd
Suite #100
Live Oak, TX 78233-3269
Phone (210) 654-0030

Other practice location 2

1 E County Line Rd
Sandwich, IL 60548-2178
Phone (815) 786-2722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081105000302 TX Practitioner - Family PracticePractitioner - Rheumatology 7810056868 Reassigns benefits to 1 organization
I20240123001182 IL Practitioner - Family Practice 7810056868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

106 S 1St St
Fairbury, IL 61739-1509
Phone (815) 692-2308

2500 W Reynolds St
Pontiac, IL 61764-9774

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036121354ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Aug 2, 2017 Accepting new patients
Saint James Hospital CurrentSince Jan 1, 2024 Accepting new patients
Saint James Hospital CurrentSince Jan 1, 2024 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Adriana Pop-Moody MD Clinic PA Past Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

106 S 1st St
Fairbury, IL 61739
Phone (815) 635-3177

106 S 1st St
Ste 100
Fairbury, IL 61739
Phone (815) 592-2380

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

1211 Austin Hwy
Ste 110
San Antonio, TX 78209
Phone (210) 774-5010

Organizations & group practices 7

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 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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1760630925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S 1ST ST STE 100",
            "city": "FAIRBURY",
            "state": "IL",
            "postal_code": "617391509",
            "telephone_number": "815-692-2308",
            "fax_number": "815-692-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S 1ST ST STE 100",
            "city": "FAIRBURY",
            "state": "IL",
            "postal_code": "617391509",
            "telephone_number": "815-692-2308",
            "fax_number": "815-692-3278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12602 Toepperwein Rd",
            "address_2": "Suite #100",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "TX",
            "postal_code": "782333269",
            "country_code": "US",
            "telephone_number": "210-654-0030",
            "fax_number": "855-278-4550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 E County Line Rd",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "IL",
            "postal_code": "605482178",
            "country_code": "US",
            "telephone_number": "815-786-2722",
            "fax_number": "815-786-6840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEINEN",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036121354",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbury, IL

Sources for this page

Verify at the official NPI Registry.