Individual provider Active NPI

Leonard B Siedband, M.D.

  • Internal Medicine Physician
  • Niles, IL
National Provider Identifier
1992754840
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036053030 Issued in IL
Practice address
7900 N Milwaukee Ave
18
Niles, IL 60714-3159
Phone
(847) 663-9700
Fax
(874) 663-9702
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036053030 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave
18
Niles, IL 60714-3159

Mailing address

7900 N Milwaukee Ave
18
Niles, IL 60714-3159
Phone (847) 663-9700

Other identifiers 1

IdentifierTypeStateIssuer
036053030MedicaidIL

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

Interoperability endpoints

  • Direct secure messaging: leonardsiedbandmd@e779e701.micromddirect.com

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1992754840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "18",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-663-9700",
            "fax_number": "874-663-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE",
            "address_2": "18",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143159",
            "telephone_number": "847-663-9700",
            "fax_number": "874-663-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEDBAND",
        "first_name": "LEONARD",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053030",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.