Leo G. Niederman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036061069 Issued in IL

Practice address

1653 W Congress Pkwy
770 Jones
Chicago, IL 60612-3244

Phone

(312) 942-1501

Fax

(312) 563-4159

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Rush Center for Congenital & Structural Heart Disease

  • Pediatric Cardiology Physician
  • Chicago, IL
  • NPI 1538355136
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1801806351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "770 JONES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-1501",
            "fax_number": "312-563-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "address_2": "770 JONES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123244",
            "telephone_number": "312-942-1501",
            "fax_number": "312-563-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERMAN",
        "first_name": "LEO",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036061069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nida a. Marouf, D.M.D., LTD.
• Daisy Nie, MD
• Jacob M Nieb, MD
• Craig S. Niederberger, M.D.
• Lauren Mae Niederkorn, LCSW
• Alfonse Niedermeyer
• Robert Martin Niedermeyer, D.O.
• Tomasz Niedziela
• Timothy Niehaus, CNIM
• Ailsa Nielsen, LCPC

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.