Individual
JESSICA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3500 W PETERSON AVE STE 401, CHICAGO, IL 60659-3307
(773) 588-3090
Mailing address
3500 W PETERSON AVE STE 401, CHICAGO, IL 60659-3307
(773) 588-3090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
008860
NY
152W00000X
Optometrist
Primary
046.011969
IL
152W00000X
Optometrist
27OA00683500
NJ
Other
Enumeration date
08/07/2018
Last updated
06/06/2025
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