Provider Demographics
NPI:1194783589
Name:LEONARD, JULIE A (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:LEONARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 COVINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8594
Mailing Address - Country:US
Mailing Address - Phone:630-243-9344
Mailing Address - Fax:
Practice Address - Street 1:60 ORLAND SQUARE DR STE 203
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6523
Practice Address - Country:US
Practice Address - Phone:708-364-7046
Practice Address - Fax:708-364-7048
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-006856103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical