Powell, Keisha Leshon

Powell, Keisha Leshon is an individual health care provider with primary practice located at 319 E Madison St Fl 3 , Springfield IL 62701. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Powell, Keisha Leshon can be contacted via phone (217) 545-8000.

Contact Information

Primary practice address
319 E Madison St Fl 3 Springfield IL 62701
Phone: (217) 545-8000
Fax: (217) 545-2275
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 036-140456 Illinois
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036.140456 Illinois

Profile Details

NPI number 1396184446
LBN Legal business name Powell, Keisha Leshon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2013
Last updated Jun 9th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396184446 NPPES
Illinois Other 036-140456 STATE LICENSE

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