Individual
DR. JACQUELINE LEE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1969 W OGDEN AVE, DEPT. OF SURGERY, CHICAGO, IL 60612-3765
(312) 996-9336
(312) 355-3763
Mailing address
840 S WOOD ST, DEPT. OF SURGERY - MC 958, CHICAGO, IL 60612-4325
(312) 996-9936
(312) 355-3763
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-097361
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036-097361
IL
Other
Enumeration date
07/13/2006
Last updated
04/26/2021
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