Leitza, Michael J
Leitza, Michael J is an individual health care provider with primary practice located at 417 E Il Route 173 Unit 101 , Antioch IL 60002-9407. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Leitza, Michael J can be contacted via phone (800) 974-4378.Contact Information
Primary practice address
417 E Il Route 173 Unit 101
Antioch IL 60002-9407
Phone: (800) 974-4378
Fax: (630) 515-1536
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 10024-24 | Wisconsin |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 070011119 | Illinois |
Profile Details
| NPI number | 1336185198 |
|---|---|
| LBN Legal business name | Leitza, Michael J |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Apr 28th, 2022 - about 4 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 | 1336185198 | NPPES |
| Wisconsin | MEDICAID | 4045700 | |
| Wisconsin | Other | 11791524 |
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