Organization
LEE JENKINS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE THOMAS JENKINS MD (MD PRESIDENT)
(708) 450-4950
Entity
Organization
Contact information
Practice address
675 W NORTH AVE, SUITE 408, MELROSE PARK, IL 60160
(708) 450-4950
(708) 343-8505
Mailing address
675 W NORTH AVE, SUITE 408, MELROSE PARK, IL 60160
(708) 450-4950
(708) 343-8505
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036088632
IL
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088632
—
IL
01
—
1623294
BLUE CROSS / BLUE SHIELD
IL
Enumeration date
06/03/2006
Last updated
09/08/2008
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