Basic Information
| Provider Information | |||||||||
| NPI: | 1861425365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVAREZ-LEONARDO | ||||||||
| FirstName: | RAMON | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1870 W GALENA BLVD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605064356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308596700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1877 W DOWNER PL | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605067302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309065151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 05/16/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 36115397 | IL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 036115397 | 05 | IL | MEDICAID | 36115397 | 01 | IL | LICENSE | OTHER |