Individual
DR. JOHN C. LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1714 S BLAINE LN, DECATUR, IL 62521-5025
(217) 423-9000
(217) 423-9002
Mailing address
1714 S BLAINE LN, DECATUR, IL 62521-5025
(217) 423-9000
(217) 423-9002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001491
HEALTH ALLIANCE
IL
01
—
0554210001
DMEPOS
IL
Enumeration date
12/22/2006
Last updated
07/08/2007
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