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Contact Information

LEONCIO S DIZON, MD
390 MAPLE SUMMIT RD
JERSEYVILLE, IL62052
 Phone: 618-498-7518
 Fax: 618-498-3052
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for LEONCIO S DIZON · (Male)

NPI # 1114982352
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2006
Last updated 11/13/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036091652
  • IL Medicaid 036091652
  • IL Other 110114535 MEDICARE RAILROAD
Hospital affiliation(s)
  • ALTON MEMORIAL HOSPITAL - (Acute Care)
    ONE MEMORIAL DRIVE
    ALTON, IL 62002
  • JERSEY COMMUNITY HOSPITAL - (Acute Care)
    400 MAPLE SUMMIT ROAD
    JERSEYVILLE, IL 62052
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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