Basic Information
| Provider Information | |||||||||
| NPI: | 1861470262 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LESNIK | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 SOUTHFIELD DR STE 1370 | ||||||||
| Address2: | |||||||||
| City: | PLAINFIELD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461684300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178375566 | ||||||||
| FaxNumber: | 3178375567 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177454451 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2006 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 115222 | MO | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 01078965A | IN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD445768 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 36305 | IA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 036107318 | IL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | ME138229 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 0470740 | 05 | IA | MEDICAID |