Individual
JASON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5230 6TH STREET FRONTAGE RD E, SPRINGFIELD, IL 62703-5128
(217) 585-5664
Mailing address
100 JENNIFER CT, CHATHAM, IL 62629-2020
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.3374522
IL
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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