Basic Information
| Provider Information | |||||||||
| NPI: | 1366489767 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEININGER | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | W180N8085 TOWN HALL RD | ||||||||
| Address2: | |||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530513518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622575100 | ||||||||
| FaxNumber: | 2625185052 | ||||||||
| Practice Location | |||||||||
| Address1: | W180N8085 TOWN HALL RD | ||||||||
| Address2: | |||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530513518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622575100 | ||||||||
| FaxNumber: | 2625185052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 11/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 0101254510 | VA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | 35838 | WI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | PENDING | 01 | VA | MEDICARE | OTHER | 32562000 | 05 | WI | MEDICAID | 1366489767 | 05 | VA | MEDICAID | PENDING | 05 | VA | MEDICAID | 1366489767 | 05 | WI | MEDICAID |