Individual provider Active NPI

Leila C Deano, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1982721890
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36-49474 Issued in IL
Practice address
4643 N Clark St
Chicago, IL 60640-4619
Phone
(773) 989-1099
Fax
(773) 989-1925
NPI assigned
Mar 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36-49474 IL Primary

Addresses

Primary practice location

4643 N Clark St
Chicago, IL 60640-4619

Mailing address

4643 N Clark St
Chicago, IL 60640-4619
Phone (773) 989-1099

Other identifiers 2

IdentifierTypeStateIssuer
036049474MedicaidIL
216-08686OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deano Medical Associates, S.C. PastSince Oct 1, 1998 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1982721890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4643 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404619",
            "telephone_number": "773-989-1099",
            "fax_number": "773-989-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4643 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404619",
            "telephone_number": "773-989-1099",
            "fax_number": "773-989-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANO",
        "first_name": "LEILA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36-49474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049474",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "216-08686",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.