Dizon, Leoncio S
Dizon, Leoncio S is an individual health care provider with primary practice located at 390 Maple Summit Rd , Jerseyville IL 62052. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Dizon, Leoncio S can be contacted via phone (618) 498-7518.Contact Information
Primary practice address
390 Maple Summit Rd
Jerseyville IL 62052
Phone: (618) 498-7518
Fax: (618) 498-3052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036091652 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036091652 | Illinois |
Profile Details
| NPI number | 1114982352 |
|---|---|
| LBN Legal business name | Dizon, Leoncio S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Mar 10th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114982352 | NPPES |
| Illinois | Other | 110114535 | MEDICARE RAILROAD |
| Illinois | MEDICAID | 036091652 | MEDICARE RAILROAD |
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