Individual
PHYLLIS LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 456-5901
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40466-020
WI
208600000X
Surgery Physician
40466-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32476700
—
WI
Enumeration date
08/19/2005
Last updated
12/02/2024
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