Provider Demographics
NPI:1346135316
Name:LEEDHAM, ISABELLA CHRISTINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:CHRISTINE
Last Name:LEEDHAM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 W AUGUSTA BLVD BSMT
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-3941
Mailing Address - Country:US
Mailing Address - Phone:913-961-9125
Mailing Address - Fax:
Practice Address - Street 1:2232 N CLYBOURN AVE # LEVEL3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3193
Practice Address - Country:US
Practice Address - Phone:773-377-5492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700291972081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine