DR. KEITH LEITZEN (NPI# 1174754139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174754139 |
| Entity Type | Individual |
| Full Name | DR. KEITH LEITZEN |
| Credential | M.D. |
| Practice Address |
800 N Westmoreland Rd Ste 102 Lake Forest IL 60045-1687 |
| Mailing Address |
650 Joel Dr Fort Campbell KY 42223-5318 |
| Practice Telephone | 8475356464 |
| Mailing Telephone | 2707988131 |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2019-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 036149517 | IL | Allopathic & Osteopathic Physicians |
| N | 207Y00000X | Otolaryngology | 0101250055 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 650 Joel Dr, Fort Campbell, KY 422235318 | 2707988131 |
| Street Address |
800 N WESTMORELAND RD STE 102 |
| City | LAKE FOREST |
| State | IL |
| Zip Code | 60045-1687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598991218 | Diana Ilinskiy | Internal Medicine | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045-1687 | 2009-06-09 |
| 1073136222 | Monica Thomas | Audiologist | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045-1687 | 2020-05-22 |
| 1194211888 | Patrick Tyler Murphy | Physician Assistant | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045 | 2018-07-05 |
| 1760829733 | Michael Kolozsvary-kiss | Internal Medicine | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045-1687 | 2013-05-30 |
| 1548512221 | Ryan T Sanders | Dietitian, Registered | 800 N Westmoreland Rd Ste 102, Lake Forest, IL 60045-1687 | 2012-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
| 1184278640 | Mary Belluomini Dipietro | Dietitian, Registered | 1000 North Westmoreland Rd., Lake Forest, IL 60045 | 2019-08-01 |
| 1336621747 | Brook Elizabeth Orvis | Physical Therapist | 1000 N Westmoreland Road, 2nd Floor, Pavilion B, Lake Forest, IL 60045 | 2018-08-31 |
| 1336621028 | Michelle Nebel | Audiologist | 225 East Deerpath, Suite 223, Lake Forest, IL 60045 | 2018-08-30 |
| 1467951731 | Devan Keesling | Audiologist | 800 N Westmoreland Rd Ste Ll30, Lake Forest, IL 60045 | 2018-02-01 |
| 1023516796 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Westmoreland Rd Ste A, Lake Forest, IL 60045 | 2018-01-29 |
| 1275056780 | Karen Elizabeth Cohen | Counselor | 1331 S. Estate Lane, Lake Forest, IL 60045 | 2017-07-18 |
| 1497281711 | Caroline Connors | Speech-Language Pathologist | 660 Westmoreland Road, Lake Forest, IL 60045 | 2017-05-05 |
| 1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
| 1225424575 | Sean Robert Wessel | Internal Medicine | 1000 N Westmoreland Rd Ste 3556, Lake Forest, IL 60045 | 2015-04-14 |
| Find all providers in zip 60045 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174501514 | Alan Freint | Otolaryngology | 990 S Waukegan Rd Ste 200, Lake Forest, IL 60045 | 2006-01-05 |
| 1699246736 | Element Med Spa, LLC | Otolaryngology | 990 S Waukegan Rd Ste 200, Lake Forest, IL 60045-2655 | 2018-12-16 |
| 1194921924 | Landon Jess Duyka | Otolaryngology | 700 N Westmoreland Rd, Suite F, Lake Forest, IL 60045-1679 | 2007-06-27 |
| 1124140652 | Lake Forest Ear Nose and Throat Ltd | Otolaryngology | 700 N Westmoreland Rd, Bld F, Lake Forest, IL 60045-1679 | 2007-04-04 |
| 1073547469 | Allen Carlins | Otolaryngology | 700 N Westmoreland Rd, Building F, Lake Forest, IL 60045-1679 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841838109 | Ryan C. Vaughn, Md Pllc | Otolaryngology | 1900 E Golf Rd Ste L125, Schaumburg, IL 60173-5831 | 2019-12-18 |
| 1265074934 | Toriumi Facial Plastics Pllc | Otolaryngology | 60 E Delaware Pl Ste 1425, Chicago, IL 60611-1998 | 2019-10-14 |
| 1184281735 | Advanced Ear Nose & Throat Specialists, Pllc | Otolaryngology | 925 N Milwaukee Ave Unit 200, Vernon Hills, IL 60061-1637 | 2019-05-20 |
| 1780144402 | Veronica Maria Drozdowski | Otolaryngology | 2160 S 1st Ave Rm 1870, Maywood, IL 60153-3328 | 2019-03-20 |
| 1205395019 | Brian Yuhan | Otolaryngology | 2160 S 1st Ave Bldg 105, Maywood, IL 60153-3328 | 2019-03-19 |
| 1285100529 | Lauren E Lesniewski | Otolaryngology | 680 N Lake Shore Dr Ste 1210, Chicago, IL 60611-4490 | 2018-10-14 |
| 1982100525 | Muyinat Yewande Osoba | Otolaryngology | 675 N. Saint Clair St, Galter Pavilion, 15th Floor, Room 200, Chicago, IL 60611-5975 | 2018-04-03 |
| 1851811343 | Peter S Dumich | Otolaryngology | 2609 S Nottingham Ct, Champaign, IL 61821-6182 | 2017-06-26 |
| 1104354414 | Sara M. Wing | Otolaryngology | 301 N 8th St Ste 5b, Springfield, IL 62701-1041 | 2017-05-31 |
| 1750734778 | Darius Bliznikas Md Sc | Otolaryngology | 7110 W 127th St Ste 210, Palos Heights, IL 60463-1580 | 2016-07-14 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 60045 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.