| Dr Leslie A Dean, MD | |
|
1511 N Blackhawk Blvd, Univ Primary Care Clinic @ Rockton, Rockton, IL 61072-1513 | |
| (815) 624-2644 | |
| (815) 624-2186 |
| Full Name | Dr Leslie A Dean |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 1511 N Blackhawk Blvd, Rockton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316912462 | NPI | - | NPPES |
| 036090988 | Other | IL | STATE LICENSE |
| 336052592 | Other | IL | CONTROLLED SUBSTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036090988 (Illinois) | Primary |
| Entity Name | The Board Of Trustees Of The University Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
| Entity Name | Saint James Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790735421 PECOS PAC ID: 0648187252 Enrollment ID: O20040804001073 |
| Entity Name | Winnebago County Health Department |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578666541 PECOS PAC ID: 0244391936 Enrollment ID: O20090119000081 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Leslie A Dean, MD 1601 Parkview Ave, Credentialing S200, Rockford, IL 61107-1822 Ph: (815) 395-5861 | Dr Leslie A Dean, MD 1511 N Blackhawk Blvd, Univ Primary Care Clinic @ Rockton, Rockton, IL 61072-1513 Ph: (815) 624-2644 |
Dr. Vasil Nika, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1511 N Blackhawk Blvd, University Primary Care Clinic @ Rockton, Rockton, IL 61072 Phone: 815-624-2644 Fax: 815-624-2186 |