DR. JAN EDWARD LEESTMA (NPI# 1205138997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205138997 |
| Entity Type | Individual |
| Full Name | DR. JAN EDWARD LEESTMA |
| Credential | MD |
| Practice Address |
1440 N Kingsbury St Suite 210 Chicago IL 60642-2651 |
| Practice Telephone | 3129882500 |
| Practice Fax Number | 3129887257 |
| Mailing Telephone | 3129882500 |
| Mailing Fax Number | 3129887257 |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZN0500X |
Pathology Specialization: Neuropathology |
036.044272 | IL | Allopathic & Osteopathic Physicians |
| N | 207ZN0500X |
Pathology Specialization: Neuropathology |
4301026842 | MI | Allopathic & Osteopathic Physicians |
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
036.044272 | IL | Allopathic & Osteopathic Physicians |
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
4301026842 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
1440 N KINGSBURY ST SUITE 210 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60642-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003441205 | Essies K Nagra | Counselor | 1440 N Kingsbury St, Chicago, IL 60642-2651 | 2020-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134612542 | Lauren Gregorcy | Social Worker | 939 W. North Avenue, Suite 750, Chicago, Illinois, 6064, Office 720, Chicago, IL 60642 | 2018-06-11 |
| 1811409030 | Athletico Ltd | Physical Therapist | 819 W Blackhawk St, Ste 819b, Chicago, IL 60642 | 2017-10-27 |
| 1346759693 | Rachel Sherron | Counselor | 938 N Elston, #1, Chicago, IL 60642 | 2017-09-28 |
| 1639612831 | Empathic Resonance, LLC | Clinic/Center | 939 W North Ave Suite 750, Office 721, Chicago, IL 60642 | 2016-11-21 |
| 1053867317 | D Jamieson Brady | Dentist | 1249 N Greenview Ave Apt 1, Chicago, IL 60642 | 2016-08-28 |
| 1548646508 | Kathryn Lee | Massage Therapist | 742 N Ada St, Unit 1, Chicago, IL 60642 | 2015-07-31 |
| 1497149694 | Neda Bahrani | Family Medicine | 1460 N Halsted St Ste 401, Chicago, IL 60642 | 2015-03-25 |
| 1326439431 | Sarah Perez | Counselor | 1332 N. Cleaver St, Apt. 2rr, Chicago, IL 60642 | 2015-02-11 |
| 1780097105 | Michael Sotiriou | Dermatology | 1765 N Elston Ave Ste 110, Chicago, IL 60642 | 2014-06-03 |
| 1285067876 | Tyler Pere Choate | Speech-Language Pathologist | 400 N. May Street, Chicago, IL 60642 | 2013-08-19 |
| Find all providers in zip 60642 | ||||
| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003270588 | Katrina Krogh | Pathology | 251 E Huron St Ste 7-132i, Chicago, IL 60611-2908 | 2016-04-11 |
| 1568858934 | Haoliang Xu | Pathology | 251 E Huron St Ste 7-332, Chicago, IL 60611-2908 | 2015-04-12 |
| 1821403569 | Elisheva Douglas Shanes | Pathology | 710 N Fairbanks Ct Ste 2-461, Chicago, IL 60611 | 2014-06-20 |
| 1295154052 | Jeffery Adam Goldstein | Pathology | 303 East Chicago Ave, Ward 3-140 W127, Chicago, IL 60611 | 2014-04-09 |
| 1912340589 | Guangyuan Li | Pathology | 251 E Huron St Ste 7-220, Chicago, IL 60611 | 2013-04-12 |
| 1164742722 | Jennifer Ann Bennett | Pathology | 5841 S Maryland Ave # Mc6101, Chicago, IL 60637-1443 | 2010-06-07 |
| 1588853733 | Martin Gross | Pathology | 5841 S Maryland, Mc 3083, Chicago, IL 60637 | 2007-10-23 |
| 1457354656 | Frederick G. Behm | Pathology | 840 S Wood St, Department of Pathology, Mc847, Chicago, IL 60612-4325 | 2005-05-23 |
| 1639639073 | Yevgen Chornenkyy | Pathology | 251 E Huron St, Chicago, IL 60611-3055 | 2019-03-21 |
| 1356845010 | Matthew Mccord | Pathology | 240 E Huron St Ste 1-203, Chicago, IL 60611 | 2018-03-19 |
| Find all providers in CHICAGO | ||||
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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.