Individual
OH JEONG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
513 RIDGE RD STE 3, MUNSTER, IN 46321-1648
(219) 513-6388
(219) 513-6389
Mailing address
513 RIDGE RD STE 3, MUNSTER, IN 46321-1648
(219) 513-6388
(219) 513-6389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01035185A
IN
207R00000X
Internal Medicine Physician
036069355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069355T2
—
IL
05
—
100014510A
—
IN
Enumeration date
06/02/2006
Last updated
03/20/2025
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