Provider Demographics
NPI:1720572506
Name:HSUEH, LEON (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:
Last Name:HSUEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1688
Mailing Address - Country:US
Mailing Address - Phone:310-825-8373
Mailing Address - Fax:310-825-3632
Practice Address - Street 1:13755 CICERO AVE
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-1824
Practice Address - Country:US
Practice Address - Phone:708-385-2400
Practice Address - Fax:708-385-7840
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP04438207R00000X
IL036164290207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine