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Individual

LEE CREPEAU CAMPANO

Active
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Individual

LEE CREPEAU CAMPANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036121158
IL
207R00000X
Internal Medicine Physician
Primary
1014913
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036121158
IL
01
920540
MEDICARE GROUP PTAN
IL
01
F400137178
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
04/17/2007
Last updated
11/07/2025
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