LEONCIO S DIZON (NPI# 1114982352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114982352 |
| Entity Type | Individual |
| Full Name | LEONCIO S DIZON |
| Credential | MD |
| Practice Address |
390 Maple Summit Rd Jerseyville IL 62052 |
| Practice Telephone | 6184987518 |
| Practice Fax Number | 6184983052 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2008-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036091652 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036091652 | 05 | |
| IL | MEDICARE RAILROAD | 110114535 | 01 |
| Street Address |
390 MAPLE SUMMIT RD |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034919 | Srirama S Kurella | Internal Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2005-09-20 |
| 1700499274 | Carrie H Purdy | Nurse Practitioner | 390 Maple Summit Rd, Illini Bldg, Jerseyville, IL 62052 | 2020-08-25 |
| 1124579099 | Mary Beck | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2016-10-17 |
| 1811392970 | Jersey Community Hospital | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2014-10-30 |
| 1578901930 | Illini Medical Associates, Sc | Durable Medical Equipment & Medical Supplies | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2013-06-07 |
| 1598036071 | Krista E Jenkins | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2012-01-16 |
| 1023259967 | Victoria Ann Hargrave | Registered Nurse | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2009-03-22 |
| 1205090644 | Colleen M Canavan | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2008-07-15 |
| 1215062914 | Cynthia Barrett | Clinical Nurse Specialist | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2007-02-22 |
| 1053345488 | Deborah Marie Seymour | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497702377 | Abbas Assar | Family Medicine | 24271 Us Highway 67, Jerseyville, IL 62052-6376 | 2006-05-27 |
| 1538162565 | Sonya R Schleeper | Family Medicine | 270 Maple Summit Rd, Jerseyville, IL 62052-2004 | 2005-05-23 |
| 1700423696 | Jersey Community Hospital | Family Medicine | 903 S State St, Jerseyville, IL 62052-2344 | 2019-12-10 |
| 1659750818 | Jersey Community Hospital | Family Medicine | 270 Maple Summit Rd, Jerseyville, IL 62052-2004 | 2015-05-21 |
| 1922056506 | Cristy A Elving-dial | Family Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2006-05-05 |
| 1427013648 | Metodia J Webster | Family Medicine | 270 Maple Summit Rd, Jerseyville, IL 62052-2004 | 2006-04-19 |
| 1760442032 | John L Palcheff | Family Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
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| City | JERSEYVILLE |
| Zip Code | 62052 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.