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Individual

DIANE C LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
401 W ELM AVE, LA GRANGE, IL 60525-2203
(708) 642-5090
(708) 579-5960
Mailing address
401 W ELM AVE, LA GRANGE, IL 60525-2203
(708) 642-5090
(708) 579-5960

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
04/28/2008
Last updated
04/28/2008
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