Individual
DR. JOHN B LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1506 W HOWARD ST, CHICAGO, IL 60626-1708
(773) 465-0695
(773) 465-4769
Mailing address
1351 W ALTGELD ST APT 4A, CHICAGO, IL 60614-2969
(773) 327-4781
(773) 465-4769
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
208000000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063002
—
IL
01
—
31600265
BC/BS
IL
Enumeration date
08/01/2006
Last updated
07/21/2011
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