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Contact Information

ERIC J LEESTMA
519 N HALLECK
DE MOTTE, IN46310
 Phone: 219-987-7750
 Fax: 219-987-5750
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ERIC J LEESTMA · (Male)

NPI Number 1700989233
Status Active
Credentials
Entity Individual
Enumeration date 09/07/2006
Last updated 05/10/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 02000641A
  • IN Medicaid 100209310A
  • IN Other 000000084931 ANTHEM BCBS
  • IN Other 36655 INDIANA HEALTH NETWORK
Hospital affiliation(s)
  • FRANCISCAN ST ANTHONY HEALTH - CROWN POINT - (Acute Care)
    1201 S MAIN ST
    CROWN POINT, IN 46307
  • PINNACLE HOSPITAL - (Acute Care)
    9301 CONNECTICUT DR
    CROWN POINT, IN 46307
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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