1093818528 NPI number — MRS. LESLIE A CLEAVER LCSW

Table of content: MS. SUSAN ELIZABETH BIELINSKI R.PH. (NPI 1598889180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093818528 NPI number — MRS. LESLIE A CLEAVER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLEAVER
Provider First Name:
LESLIE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLEAVER
Provider Other First Name:
LESLIE
Provider Other Middle Name:
ARANOA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1093818528
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3701 N GREENVIEW AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60613-7078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-263-1230
Provider Business Mailing Address Fax Number:
888-876-6566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3701 N GREENVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60613-7078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-263-1230
Provider Business Practice Location Address Fax Number:
888-876-6566
Provider Enumeration Date:
09/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149001951 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001605153 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001605153 . This is a "BLUE CROSS PPO" identifier . This identifiers is of the category "OTHER".